The 2018 AAP/EFP Classification of Periodontal & Peri-implant Diseases
Course Number: 610
Course Contents
Necrotizing Periodontal Diseases
Patients falling under this category present with three typical clinical features: necrosis of the papilla, bleeding; and pain. This condition is associated with an impairment of the host immune response.17 Table 6 illustrates the key features of this classification.
Image Courtesy of Dr. C. Cobb.
Table 6. Classification of Necrotizing Periodontal Diseases.
| Patient Category of Necrotizing Periodontal Disease | Patients | Predisposing Conditions | Clinical Condition |
|---|---|---|---|
| Severely & Chronically Compromised | Adult | - HIV+/AIDS with CD4 counts <200 & detectable viral load - Other severe systemic conditions that cause immunosuppression | Necrotizing Gingivitis (NG) Necrotizing Periodontitis (NP) Necrotizing Stomatitis (NS) Noma Possible progression |
| Child | - Severe malnourishments - Extreme living conditions - Severe viral infections | ||
| Temporarily or Moderately Compromised | Gingivitis Patient Periodontitis Patient | - Uncontrolled factors: stress, nutrition, smoking, habits - Previous NPD (residual craters) | Generalized NG Possible progression to NP |
| Local Factors: root proximity, tooth malposition | Localized NG Possible progression to NP | ||
| Common Predisposing Factors | NG Infrequent Progression NP infrequent progression |
Adapted from Papapanou et al. 2018.17
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