A simple 4-step process has been suggested by Kornman and Papapanou17 to assist clinicians in developing a diagnosis for each individual case using the new classification.
Step 1 - Case Overview
This will help to first determine whether the case is: Mild/Moderate or Severe/Very Severe
Step 2 - Determine Stage
Step 3 - Determine Grade
Examples:
Staging
PD = ≤ 4 mm
BOP = Yes
RBL < 15% & generally horizontal
CAL 1-2 mm
Biofilm = Slight–Heavy
Grading
No tooth loss due to periodontitis
Moderate Rate of Progression
Non-Smoker
Non-Diabetic
Staging
PD ≤ 5 mm
BOP = Yes
RBL = 15% - 33% / mostly horizontal
CAL 3-4 mm
Biofilm = Slight–Heavy
Grading
No tooth loss due to periodontitis
Moderate Rate of Progression
Smoker <10 cigs per day
If Diabetic HbA1c <7.0%
Staging
PD ≥ 6 mm
BOP = Yes
RBL = Horizontal ≥ 50% / Vertical ≥ 3 mm
CAL ≥ 5 mm
Biofilm = Slight–Heavy
Grading
Tooth loss due to periodontitis ≤ 4 teeth
Moderate Rate of Progression
Furcation Involvement = Class II or III
If Smoker <10 cigs per day
If Diabetic HbA1c <7.0%
Moderate ridge defect
Staging
PD ≥ 6 mm
BOP = Yes
RBL = Horizontal ≥ 50% / Vertical ≥ 3 mm
CAL ≥ 5 mm
Biofilm = Slight–Heavy
Grading
Tooth loss due to periodontitis ≥ 5 teeth
Furcation Involvement = Class II or III
Moderate ridge defect
Need for complex rehabilitation
Bone loss exceeds expectations given biofilm
Rapid Rate of Progression
Smoker >10 cigs per day
If Diabetic HbA1c >7.0%
Please note: These examples do not include categorization of the extent of disease, thus keep in mind that localized would be any case that had less than 30% of teeth involved, while generalized would be more than 30% of teeth involved.
