📌 POINTS TO PONDER 

➡️ Main features of AAP 1999 classification system are as follows:

🔹Addition of gingival disease component: Comprehensive section of gingival diseases is included in this classification.

🔹Replacement of adult periodontitis with chronic periodontitis: There is replacement of the term “adult periodontitis” with chronic periodontitis, since epidemiological evidence suggests that chronic periodontitis may also be seen in adolescents.

🔹 Discontinuation of term “refractory periodontitis”: There is elimination of separate categories of rapidly progressive periodontitis and refractory periodontitis because of the lack of evidence that they represent separate conditions.

🔹 Replacement of early-onset periodontitis with aggressive periodontitis: The term juvenile periodontitis was replaced by aggressive periodontitis and this replacement is because of the clinical difficulties in determining the age of onset in many of these cases. The term “aggressive” was added as tissue and bone destruction occurs rapidly as compared with other periodontitis.

🔹Replacement of NUP with necrotizing periodontal diseases.

🔹 A new classification group of periodontitis as a manifestation of systemic disease has been added and  this includes those cases of prepubertal periodontitis directly resulting from known systemic diseases.

🔹 Addition of new group categories of abscesses of the periodontium and periodontic–endodontic lesions.

🔹 Addition of new category of developmental/acquired conditions/deformities.

📌 MULTIPLE CHOICE QUESTIONS MCQs

💡According to the 1999 classification of disease andconditions affecting periodontium the ascorbic acid deficiency gingivitis is included in:

A. Gingival disease modified by systemic factors

B. Gingival manifestation of systemic condition

C. Gingival disease modified by malnutrition

D. Gingival disease modified by medication.

Answer : C

💡 In 1989 AAP classification following condition is notincluded:

A. Dental plaque induced gingival diseases

B. Refractory periodontitis

C. Necrotizing ulcerative periodontitis

D. Adult periodontitis

Answer : A

💡In 1999 AAP classification following condition is notincluded:

A. Localized aggressive periodontitis

B. Generalized chronic periodontitis

C. Refractory periodontitis

D. Non-plaque induced gingival lesion

Answer : C

📌 VIVA VOCE

Q 1. In which classification system, gingival diseases were not included?

Ans. In 1989 AAP Classification, gingival diseases were not included.

Q2. What was the basic difference between AAP 1989 and Ranney 1993 classification system? 

Ans. AAP 1989 classification system eliminated “Refractory periodontitis” and “Periodontitis associated with systemic disease” categories.

Q3. In which classification system, abscesses of the periodontium were added?

Ans. In 1999 AAP Classification, abscesses of the periodontium were added.

Q4. What is the major drawback associated with 1999 AAP Classification?

Ans. It is very extensive and comprehensive.

Q5. In which classification system, the term “Aggressive periodontitis” was introduced?

Ans. 1999 AAP Classification.

Q6. What are the three dominant paradigms related to periodontal diseases classification system?

Ans. • Phase I (1870–1920): Clinical characteristicsparadigm.

• Phase II (1920–1970): Classical pathologyparadigm.
• Phase III (1970 to present): Infection/Hostresponse paradigm.

Q7. In which classification system, early-onset periodontitis was replaced with aggressive periodontitis?

Ans. 1999 AAP Classification

Q8. Why was the term early-onset periodontitis replaced with aggressive periodontitis?

Ans. The term early-onset periodontitis was replaced by aggressive periodontitis because of the clinical difficulties in determining the age of onset in these cases.

Q9. What are the systemic diseases related to early-onset periodontitis?

Ans. Leukocyte adhesion deficiency, hypophosphatasia, Papillon–Lefèvre syndrome, neutropenias,leukemias, Chediak–Higashi syndrome, AIDS, diabetes mellitus type I, trisomy 21,histiocytosis X, Ehlers–Danlos syndrome (type VIII).

Q10. In which classification system, the category namely developmental/acquired conditions/ deformities was added?

Ans. 1999 AAP Classification.