STEP 3a Patient is a periodontitis case whose stage needs to be established
To establish the stage of an individual case of periodontitis, the following information is needed: full mouth x-rays, a periodontal chart, and a periodontal history of tooth loss (PTL). First, we assess the extent of the disease, by assessing whether the CAL/BL affects less than 30% of the teeth (local) or 30% or more (generalised). Then, we define the stage of the disease by assessing severity (using CAL, BL, and PTL) and complexity (by assessing PPD, furcation and intrabony lesions, tooth hypermobility, secondary occlusal trauma, bite collapse, drifting, flaring, or having fewer than 10 occluding pairs of teeth).
Periodontitis case
Periodontal chart
Periodontal history (PTL)
Full mouth x-rays
Periodontitis case
< 30%
Periodontal & bone appraisal
Extent (% teeth)
30% or more
Periodontitis case
Severity & complexity
CAL loss, bone loss, periodontal tooth loss
Severity of breakdown
Pocket depth, intrabony defects, furcation, tooth hypermobility, secondary occlusal trauma, bite collapse, drifting, flaring, < 10 occluding pairs
Complexity of management
Stage I periodontitis
Stage II periodontitis
Stage III periodontitis
Stage IV periodontitis
Proceed to grading
Periodontitis: clinical decision tree for staging and grading
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Guidance for clinicians
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