Tonetti et al reported criteria for staging and grading periodontitis. The authors are from the University of Hong Kong, University of Louisville and University of Michigan.
Parameters:
(1) interdental clinical attachment loss (CAL) at site of greatest loss in mm
(2) radiographic bone loss
(3) tooth loss due to periodontitis
(4) maximum probing depth
(5) bone loss
(6) other elements of complexity
Parameter
Finding
Stage
interdental CAL
1-2 mm
1 (initial)
3-4 mm
2 (moderate)
>=5 mm
3 (severe)
radiographic bone loss
coronal third (< 15%)
1
coronal third (15-33%)
2
middle to apical third of root
3
tooth loss from periodontitis
none
1
1 - 4 teeth
3
>= 5 teeth
4 (advanced)
maximum probing depth
<= 4 mm
1
5 mm
2
>= 6 mm
3
bone loss
mostly horizontal
1
vertical >= 3 mm
3
other elements of complexity
furcation involvement Class II or III; moderate ridge defect
3
masticatory dysfunction; severe ridge defect; bite collapse/drifting/flaring; less than 20 remaining teeth; tooth mobility degree >= 2
4
In addition, the extent and distribution is added as a descriptor - one of the following:
(1) localized (< 30% of teeth generalized)
(2) generalized
(3) molar/incisor pattern
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