Please respond to four classmates with a paragraph for each. I want the feedback to be thoughtful rather than simply rephrasing or agreeing with their points. You must explain why you agree with their
Peer #1
AAP Outline
I. Title: Current AAP Classification system-2017
II. Main purpose: A. Understand periodontitis and classify staging and grading
B. Implement the addition of Peri-implantitis and peri-implant mucositis
C. Identify the three major forms of periodontitis including necrotizing periodontal diseases, and periodontitis as a manifestation of systemic disease
III. Periodontitis: a complex chronic inflammatory and multifactorial condition that leads to permanent loss of the periodontium
A. Periodontitis Staging: interdental CA, tooth loss due to periodontitis, the trend of bone loss in horizontal or vertical, furcation involvement and radiographic bone loss must be determined
B. Stage I to IV goes from slight periodontitis to severe periodontitis with potential loss of dentition
C. Periodontitis Grading: Determining the chance of progression of the disease due to modifying risk factors: smoking status and HbA1c levels.
IV. Peri-implantitis and peri-implant mucositis
A. Peri-implant tissue health is different from periodontal tissue health. No clinical signs of inflammation, no bleeding on probing depths of ≤ 5mm is considered healthy.
B. Peri-implant mucositis is the inflammation of the tissue around the implant compared to the tissue at the initial placement of the tissue with no radiographic evidence of bone loss.
C. Peri-implantitis is inflammation of the tissue around the implant with evidence of bone loss and compromised osteointegration
V.Periodontitis as a manifestation of systemic disorders and Necrotizing Periodontal Diseases
A. Genetic disorders, diseases affecting oral tissue, metabolic and endocrine disorders, acquired immunodeficiency diseases impact the loss of periodontal attachment by influencing periodontal inflammation.
B. Conditions that influence the pathogenesis of periodontal disease includes diabetes mellitus, obesity, smoking, depression, and more. Neoplastic diseases of the periodontium results in attachment loss independent of dental plaque biofilm induced inflammation.
C. Medically compromised patients with severe or moderate chronic conditions with impaired immune system has more of a risk of developing necrotizing gingivitis, periodontitis and stomatitis.
VI. Conclusion
A. This article explains the updated classification of stages and grading of periodontitis and peri-implant diseases and conditions.
B. Communication with patients and other healthcare professionals can become more efficient through a more specific classification system.
Peer #2 AAP Outline for Periodontal Disease
I. Title: The A,B,Cs and I,II, IIIs of Periodontitis Staging and Grading
II. Main purpose:
A. Understand the stages and grading system of periodontal and peri-implant diseases.
B. Apply the 2018 periodontal classification framework to patient cases while recognizing the value of assessing disease complexity and potential for future progression.
III. Periodontitis: A chronic inflammatory disease caused by many different factors that is irreversible and progresses throughout time resulting in loss of periodontal attachment and supporting bone and possibly loss of teeth too if left untreated.
A. To determine whether periodontal disease is present, it is necessary to understand the staging system, which ranges from Stage I through Stage IV. Periodontal disease is assessed by evaluating radiographic bone loss, furcation involvement, clinical attachment loss (CAL), and loss of dentition. Once periodontal disease is identified, the next step is to classify it using the staging system. Stage I represents the beginning of the disease with no more than 2mm of interdental CAL and is considered slight periodontitis. Stage II is moderate periodontitis having CAL 3-4mm, no loss of dentition. Stage III is risk of tooth loss and CAL of 5mm or more. Stage IV is severe periodontitis with five or more teeth lost due to the progression of periodontal disease.
B. In addition to staging, periodontal disease is also determined by a grading system that evaluates the disease progression. Risk factors play an important role in periodontal disease progression, with smoking and diabetes being well-established contributors. Other lifestyle and genetic factors may further impact the health of the periodontium. Periodontitis progression can vary from one individual to another; some may have generalized or localized periodontitis. Grade A represents slow progression, Grade B is moderate progression, and Grade C is rapid progression.
IV. Peri-implantitis and peri-implant mucositis: Peri-implant diseases and conditions are identified by the health of the tissues surrounding dental implants and are based on signs and symptoms.
A. Healthy peri-implant tissues should not show signs of inflammation such as swelling, redness, or profuse bleeding on probing. Probing depths around peri-implants are typically less than or equal to 5 mm; however, slight bleeding may occur due to tissue trauma during probing. It is also important to note that probing depths around implants may be greater than those around natural teeth because of differences in tissue adaptation.
B. Peri-implant mucositis is inflammation of the gums around the implant without any bone loss.
C. Peri-implantitis gums are inflamed around the implant, and bone loss is occurring and not supporting the implant to the bone as well as it should.
V. Periodontitis as a manifestation of systemic disorders: Systematic conditions that affect the immune and inflammatory response, impacting periodontal health.
A. Conditions that affect overall systemic health can influence oral inflammation and contribute to periodontal attachment loss. Examples include metabolic, genetic, immune, and connective tissue disease.
B. Smoking, stress, and diabetes are contributors that affect how periodontal disease develops and progresses over time.
C. Dental plaque biofilm is not always the cause of periodontal attachment loss, as certain systemic conditions can directly affect the tissues that support the teeth.
VI. Necrotizing Periodontal Diseases: Individuals with moderate to severe chronic conditions that impair immune function, such as HIV/AIDS, smoking-related conditions, stress, or malnutrition, have a higher risk of developing necrotizing periodontal diseases.
A. Necrotizing gingivitis (NG) is a sudden gum infection that occurs when the immune system is weakened. It is diagnosed by three main signs: gum pain, bleeding, and tissue breakdown between the teeth. Other symptoms may include fever, swollen lymph nodes, and bad breath.
B. Necrotizing periodontitis (NP) shows similar signs to Necrotizing gingivitis (NG) but is more severe than necrotizing periodontal disease and also includes loss of periodontal attachment and bone between the teeth.
C. Necrotizing stomatitis (NS) occurs when tissue damage spreads beyond the gums to involve deeper oral tissues. This condition is often associated with severe immune compromise and can lead to extensive tissue destruction.
Peer #3 AAP Outline for Periodontal Disease
I. TITLE: Using staging and grading to classify the severity of periodontal disease in dental hygiene.
II. Main purpose:
A. To understand and be educated on the different classification systems of periodontal disease to care for patients accordingly.
B. To divide gingivitis and periodontitis into categories to be able to provide a thorough and accurate treatment plan that tailor to the needs of our patients.
C. To explain the effects that systemic diseases have on oral health.
III. GINGIVITIS: A reversible disease that causes inflammation in the gums with a minimum of a 30% bleeding index.
A. Inflamed gingiva due to plague buildup, inadequate oral hygiene, smoking, or taking medications.
B. Can also be due to things that are out of our control as in hormonal changes in the body, systemic diseases, and genetics.
IV. THE DIFFERENT FORMS OF PERIODONTITIS: Periodontitis, necrotizing periodontal diseases, and periodontitis as a manifestation of systemic disease.
A. The classifications are of periodontitis include the stage 1-4 (not fluid-does not change), the grade A-C (fluid-can change), and the extent. The grading and staging depend on bone loss, number of teeth lost due to bone loss, probing depths, systemic diseases like diabetes, smoking habits, clinical attachment loss, and furcations.
B. Necrotizing Periodontal Disease include necrotizing gingivitis, necrotizing periodontitis, and necrotizing stomatitis.
V. SYSTEMIC DISEASES: Systemic diseases can increase the risk of developing periodontal disease and affect the level of alveolar bone.
A. Genetic disorders, AIDS, and inflammatory diseases can cause a major impact on periodontal tissues by causing inflammation.
B. Diabetes, smoking, and stress influence the pathogenesis of periodontal disease.
C. Systemic disorders like Down Syndrome, leukocyte adhesion deficiency, Papillon-Lefevre syndrome, cyclic neutropenia, Chediak-Higashi, etc, can increase risk of developing periodontal disease.
VI. CONCLUSION:
A. This article goes in depth about the staging and grading system of periodontal disease and how to properly utilize it preforming assessments on our patients.
B. Making sure you are up to date with updated research and newest scientific evidence is important to provide the best care.
Peer #4 AAP ARTICLE OUTLINE
I. The A,B,Cs, and I,II,IIs of Periodontitis Staging and Grading
II. Main purpose:
A. To learn how to classify the stages and grades of periodontal and Peri-implant Diseases
B. Applying the classification of periodontal disease to patient cases
III. Periodontitis: A complex chronic inflammatory condition that, if left unmanaged, can lead to permanent loss of periodontium due to bacterial infections and poor host response, classified by its degree of advancement, extent, and complexity.
A. When trying to classify periodontitis, we first must give it a "stage". We do so by a few different factors, such as CAL, loss of dentition due to Perio, trend in bone loss ( vertical vs horizontal), furcation, and radiographic images. Based on these sevrity of these factors, a patient can fall in to 1 of 4 categories: stage 1, Slight Perio, Stage 2, Moderate Perio, stage 3, Severe Perio with potential loss of tooth, and stage 4, Severe Perio with potential loss of dentition.
B. After finding the correct stage, we can now find the correct "grade". This is determined by risk factors that control the rate of your perio progression, such as smoking, diabeties or heavy biofilm. These grades fall into 3 categories. A slow rate of progression. B moderate rate of progression and C rapid rate of progression. Now it's important to know that if a patient is diagnosed with perio you will automatically fall into grade B, and as a dental hygenist it is our job to prove weather a patient is A, B or C.
IV. Peri-implantitis and peri-implant mucositis: Periodontial disease and gingivitis as related to a implant related tooth
A. Peri- implantitis is recognized when an implant tooth is surrounded by inflamed mucosal tissue followed by constant patterens of consistant bone loss and pocket depths grater than 5mm.
B. Peri-implant mucositis is a little less severe and is charecterized as inflamation of the ginigival structure without signs of bone loss.
V. Periodontitis as a manifestation of systemic disorders: Periodontial disease caused by systemic conditions opposed to biofilm and calculus buildup.
A. Certain systematic conditions, such as Down syndrome, will influence the inflammation of the periodontium.
B. Other factors, such as stress, obesity, and smoking, increase pathogenesis and cause periodontal disease.
C. Certian syestmatic dieses such as odontogenic tumours can affect the attachment of the periodontium.
VI. Necrotizing Periodontal disease: Medically compromised patients with severe or moderate chronic conditions that compromise the immune system are classified into three subgroups. necrotizing gingivitis (NG) , necrotizing Periodontitis ( NP), and Necrotizing stomatitis( NS).
A. Necrotizing gingivitis can be classified as an acute infection of the gingiva due to sytematic diseas, with symptoms of bleeding, pain, and necrosis of the interdental papilla.
B. Necrotizing periodontitis is similar to NG with signs and symptoms, except it follows with CAL and necrosis of the alveolar bone.
C. Necrotizing stomatitis is explained as extensive necrosis of the soft and hard tissue, extending deep into the alveolar bone.
VII: CONCLUSION: The article goes into the depth of the 3 forms of periodontitis, how to properly classify each form, and how to correctly assign it to a Patient based on that patients syematic condition.
