Abstract
Juvenile periodontitis (1977, AAP) was renamed as aggressive periodontitis at the International Workshop for a Classification of Periodontal Diseases and Conditions in 1999. In 2017, the AAP and EFP (European Federation of Periodontology) jointly reached the consensus that invasive periodontitis, which had been distinguished from “chronic periodontitis,” could not be proven to be a pathophysiologically distinct disease, and the category of periodontitis was unified to periodontitis and classified according to its severity, rate of progression and extent. The new classification is characterized by (1) the definition of the disease at the patient level rather than at the local condition, (2) the stage (severity) and the extent to assess the complexity in respect to disease control as well as management and maintenance of dentition, and (3) the grade (rate of progression) to estimate the future risk of periodontitis progression and the likely responsiveness to standard therapeutic principles. This resolved the paradox that tooth loss was included in the index of severity and that extraction reduced the severity of the disease. Grades may have become useful as therapeutic indicators because they assess not only the status of bone resorption, but also the risk of progression and responsiveness to treatment, but no biomarker has been established to distinguish between the grades.
