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Socransky SS, Haffajee AD. The bacterial etiology of destructive periodontal disease: current concepts. J Periodontol. 1992; 63:322-331
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Diagnosis and management of chronic and aggressive periodontitis part 1: periodontal assessment and diagnosis

From Volume 44, Issue 4, April 2017 | Pages 306-315

Authors

Despoina Chatzistavrianou

DDS MFDS RCSEd, MClinDent Pro, MPros RCSEd

Specialist in Prosthodontics, Specialty Registrar in Restorative Dentistry, Birmingham Dental Hospital and University of Birmingham School of Dentistry, Birmingham Community Healthcare NHS Trust, Birmingham, UK

Articles by Despoina Chatzistavrianou

Fiona Blair

BDS, LDS, FDS(Rest) RCPS, MSc, DRD, MRD

Consultant in Restorative Dentistry, Birmingham Dental Hospital, St Chad's Queensway, Birmingham B4 6NN, UK

Articles by Fiona Blair

Abstract

Periodontal disease remains one of the most common diseases that affect the oral cavity. The differential diagnosis between chronic and aggressive periodontitis can be complex for some clinicians and the correct diagnosis is a key element in disease management. The three-part series will review periodontal clinical assessment and diagnosis, periodontal management and finally will discuss two clinical cases. This paper will focus on periodontal disease pathogenesis, periodontal clinical assessment and diagnosis.

CPD/Clinical Relevance: This paper aims to provide the general dental practitioner with an understanding of periodontal disease pathogenesis and to highlight elements in the clinical assessment which will help to establish the diagnosis.

Article

Periodontal disease is a complex inflammatory disease that affects the periodontal structures, including the gingiva, cementum, periodontal ligament and alveolar bone.1 Both chronic and aggressive periodontitis are plaque-related diseases initiated by bacteria (Figure 1).2 The host response, genetic predisposition and environmental risk factors do not initiate periodontal disease, however, can influence the extent and severity of periodontal disease (Table 1,Figure 2).3,4,5,6

Subgingival plaque consists of a large and complex bacterial mixture of 400 or more species; certain bacterial combinations, under specific circumstances, can promote periodontal tissue breakdown.7 The bacterial species involved in the initiation and progression of periodontal disease have been classified based on their pathogenicity and grouped into complexes (Figure 3).8

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