Periodontal health and gingival diseases and conditions on an intact and a reduced periodontium: Consensus report of workgroup 1 of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions.

Chapple, Iain L C; Mealey, Brian L; Van Dyke, Thomas E; Bartold, P Mark; Dommisch, Henrik; Eickholz, Peter; Geisinger, Maria L; Genco, Robert J; Glogauer, Michael; Goldstein, Moshe; Griffin, Terrence J; Holmstrup, Palle; Johnson, Georgia K; Kapila, Yvonne; Lang, Niklaus Peter; Meyle, Joerg; Murakami, Shinya; Plemons, Jacqueline; Romito, Giuseppe A; Shapira, Lior; ... (2018). Periodontal health and gingival diseases and conditions on an intact and a reduced periodontium: Consensus report of workgroup 1 of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions. Journal of periodontology, 89(Suppl 1), S74-S84. American Academy of Periodontology 10.1002/JPER.17-0719

[img] Text
Chapple_et_al-2018-Journal_of_Periodontology.pdf - Published Version
Restricted to registered users only
Available under License Publisher holds Copyright.

Download (359kB) | Request a copy

Periodontal health is defined by absence of clinically detectable inflammation. There is a biological level of immune surveillance that is consistent with clinical gingival health and homeostasis. Clinical gingival health may be found in a periodontium that is intact, i.e. without clinical attachment loss or bone loss, and on a reduced periodontium in either a non-periodontitis patient (e.g. in patients with some form of gingival recession or following crown lengthening surgery) or in a patient with a history of periodontitis who is currently periodontally stable. Clinical gingival health can be restored following treatment of gingivitis and periodontitis. However, the treated and stable periodontitis patient with current gingival health remains at increased risk of recurrent periodontitis, and accordingly, must be closely monitored. Two broad categories of gingival diseases include non-dental plaque biofilm-induced gingival diseases and dental plaque-induced gingivitis. Non-dental plaque biofilm-induced gingival diseases include a variety of conditions that are not caused by plaque and usually do not resolve following plaque removal. Such lesions may be manifestations of a systemic condition or may be localized to the oral cavity. Dental plaque-induced gingivitis has a variety of clinical signs and symptoms, and both local predisposing factors and systemic modifying factors can affect its extent, severity, and progression. Dental plaque-induced gingivitis may arise on an intact periodontium or on a reduced periodontium in either a non-periodontitis patient or in a currently stable "periodontitis patient" i.e. successfully treated, in whom clinical inflammation has been eliminated (or substantially reduced). A periodontitis patient with gingival inflammation remains a periodontitis patient (Figure 1), and comprehensive risk assessment and management are imperative to ensure early prevention and/or treatment of recurrent/progressive periodontitis. Precision dental medicine defines a patient-centered approach to care, and therefore, creates differences in the way in which a "case" of gingival health or gingivitis is defined for clinical practice as opposed to epidemiologically in population prevalence surveys. Thus, case definitions of gingival health and gingivitis are presented for both purposes. While gingival health and gingivitis have many clinical features, case definitions are primarily predicated on presence or absence of bleeding on probing. Here we classify gingival health and gingival diseases/conditions, along with a summary table of diagnostic features for defining health and gingivitis in various clinical situations.

Item Type:

Journal Article (Review Article)


04 Faculty of Medicine > School of Dental Medicine > Department of Periodontology
04 Faculty of Medicine > School of Dental Medicine > School of Dental Medicine, Periodontics Research

UniBE Contributor:

Lang, Niklaus Peter


600 Technology > 610 Medicine & health




American Academy of Periodontology




Doris Burri

Date Deposited:

18 Jul 2019 13:07

Last Modified:

22 Oct 2019 21:06

Publisher DOI:


PubMed ID:


Uncontrolled Keywords:

Crohn's disease Hodgkin lymphoma Melkersson-Rosenthal Mycobacterium tuberculosis Neisseria gonorrhoeae Treponema pallidum allergic reaction amalgam tattoo aspergillosis biofilm blastomycosis calcifying fibroblastic granuloma candidosis chemical trauma clinical health coccidioidomycosis condylomata acuminatum contact allergy coxsackie virus dental plaque-induced gingivitis disease control disease remission disease stability drug-induced gingival enlargement drug-induced pigmentation dysbiosis erythema multiforme erythroplakia factitious injury fibrous epulis focal epithelial hyperplasia frictional keratosis geotricosis gingival pigmentation hand foot and mouth hereditary gingival fibromatosis herpangina herpes simplex histoplasmosis hyperglycemia hyposalivation intact periodontium leukemia leukoplakia lichen planus local risk factors lupus erythematosus melanoplakia menstrual cycle modifying factors molluscum contagiosum mucormycosis necrotizing periodontal diseases non-Hodgkin lymphoma non-dental plaque-induced gingival conditions oral contraceptive orofacial granulomatosis paracoccidioidomycosis pemphigoid pemphigus vulgaris periodontal disease peripheral giant cell granuloma plasma cell gingivitis predisposing factors pregnancy puberty pyogenic granuloma reduced periodontium resolution of inflammation restoration margins sarcoidosis scurvy smoker's melanosis smoking squamous cell carcinoma squamous cell papilloma stable periodontitis streptoccocal gingivitis symbiosis systemic risk factors thermal trauma toothbrush trauma varicella zoster vascular epulis verruca vulgaris




Actions (login required)

Edit item Edit item
Provide Feedback