Tonetti et al reported criteria for staging and grading periodontitis. Grading is based on the progression rate of the periodontitis. The authors are from the University of Hong Kong, University of Louisville and University of Michigan.
Patient selection: periodontitis
Grades:
(1) Grade A: slow rate of progression
(2) Grade B: moderate rate of progression
(3) Grade C: rapid rate of progression
Parameters:
(1) radiologic bone loss over 5 years
(2) case phenotype
(3) smoking
(4) diabetes
(5) serum high sensitivity CRP in mg/L (as marker of inflammatory burden)
Parameter
Grade A
Grade B
Grade C
bone loss
no loss
< 2 mm
>= 2 mm
case phenotype
heavy biofilm deposits with low levels of destruction
destruction commensurate with biofilm deposits
destruction exceeds expectation
smoking
nonsmoker
< 10 cigarettes per day
>= 10 cigarettes per day
diabetes
absent
diabetes with HbA1c < 7%
diabetes with HbAqc >= 7%
serum hsCRP
< 1 mg/L
1-3 mg/L
> 3 mg/L
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