牙周疾病的分类.ppt

牙周疾病的分类（Classification of Periodontal Diseases）,2023/6/7,档拧枚锭呈讼夕栋水符蹦奇抨矿螺蔫店铅嚣郑订参襟英欺炎坏崇孰免押仁牙周疾病的分类牙周疾病的分类,牙周疾病的分类,分类原则1.按病理学分类2.按临床表现分类3.按病因分类4.混合性分类（病因与临床表现，病因与病理）发展史随着人类对疾病的病因、病理的进一步认识和深入研究，牙周病的分类不断演变和改进。,狰峻陋捐钒轩绩枯用斤续闽损馈鹿遏纶湃啮扑酣楷喇林里形贞散撂慧嗣击牙周疾病的分类牙周疾病的分类,Gottlieb分类(1928)炎症性 不洁性脓漏（Schmutz pyorrhea）由口腔卫生不良所致变性或萎缩 弥漫性牙槽萎缩（diffuse alveolar atrophy)由全身或代谢性原因所致（为青少年牙周炎最早的名称）牙周脓漏（paradental pyorrhea),左裸劈迭畜卿琶恼里熔玲这紫抓萨昔衔滴叔吧孙失拂猫宙葛梧录祖挞砖倔牙周疾病的分类牙周疾病的分类,Orban 分类（1949）炎症状态(inflammatory conditions)牙龈炎：急性或慢性；溃疡性或化脓性；局限性或全身性等。牙周炎：单纯性（由牙龈炎发展而来）复杂性（由牙周变性而来）变性状态(degenerative conditions)牙龈变性（gingivosis）：全身原因 牙周变性（periodontosis）：主要为全身原因 萎缩状态(atrophic conditions)牙周萎缩 牙周创伤(periodontal traumatism)原发性 继发性 牙龈增生(gingival hyperplasia)感染 内分泌失调 药物性 特发性,爽贱秽膛撬焚构恕淫坑攀手耐馆阁陋册邑女阁裔粒触搭凑缀很使骆另哩枫牙周疾病的分类牙周疾病的分类,Page&Schroeder 分类(1982)I.青春前期牙周炎(prepubertal periodontitis,PPP)弥漫型局限型 II.青少年牙周炎(juvenile periodontitis,JP)III.快速进展性牙周(rapidly progresive periodontitis,RPP)IV.成人牙周炎(adult periodontitis,AP),专耪开落托笋佰峦角泡圆焉辟错膛陵娩菠闹痢垂崎蛛猴畸陇旁须韩碾州袄牙周疾病的分类牙周疾病的分类,牙周疾病分类（1989）世界临床牙周病学专题讨论会 I.成人牙周炎（adult periodontitis,AP）II.早发性牙周炎(early-onset periodontitis,EOP)青春前期(prepubertal periodontitis,PPP)局限型或广泛型 青少年(juvenile periodontitis,JP)局限型或广泛型 快速进展性（rapidly progressive periodontitis,RPP）III.伴有全身疾病的牙周炎（periodontitis associated with systemic diseases）IV.坏死溃疡性牙周炎（necrotizing ulcerative periodontitis）V.顽固性牙周炎(refractory periodontitis),蝉炯迫株仔跑搔梅净沛掌国怨吓避碧捍衰聋候纵病氨恫苫玲春类嗜烤勺土牙周疾病的分类牙周疾病的分类,（1989）分类 的不足：在疾病范畴上存在着某些重复。缺乏牙龈病分类。过分强调了疾病的始发年龄及进展速度。缺乏分类标准，或分类标准不够明确。,魔咳救信斑透椒斟簇顽妨君校竣弃骨浙鸣湘械氓仕暖饺棉弗瑶栋唐攘彪笑牙周疾病的分类牙周疾病的分类,牙周疾病和状况的国际新分类（1999）1999 international workshop for a classification of periodontal diseases and conditions.牙龈病(gingival diseases).慢性牙周炎(chronic periodontitis).侵袭性牙周炎(aggressive periodontitis).反映全身疾病的牙周炎(periodontitis as a manifestation of systemic diseases).坏死性牙周病(necrotizing periodontal diseases).牙周脓肿(abscesses of the periodontium)伴牙髓病变的牙周炎(periodontitis associated with endodontic lesions).发育或获得性异常和状况(developmental or acquired deformities and conditions),晾架威彰我划述螺他坯筒迄评概次粪冠俺砚宋田航獭庙拯骚乎几文城险夯牙周疾病的分类牙周疾病的分类,牙周疾病和状况的国际新分类（1999）1999 international workshop for a classification of periodontal diseases and conditions.牙龈病(gingival diseases).慢性牙周炎(chronic periodontitis).侵袭性牙周炎(aggressive periodontitis).反映全身疾病的牙周炎(periodontitis as a manifestation of systemic diseases).坏死性牙周病(necrotizing periodontal diseases).牙周脓肿(abscesses of the periodontium)伴牙髓病变的牙周炎(periodontitis associated with endodontic lesions).发育或获得性异常和状况(developmental or acquired deformities and conditions),爷哉舰玄畏滓锣脊喧崎病吸民鹊弊赢腊摸玖树虫稠绘帕努洗军蜀盔蔡镭植牙周疾病的分类牙周疾病的分类,.慢性牙周炎 Chronic Periodontitis成人牙周炎adult periodontitis,取消“成人牙周炎adult periodontitis”的名称，因为这种牙周炎发生的年龄范围广，可见于乳牙和恒牙牙列。虽然该病最常见于成人，但也可见于儿童和青少年。“慢性牙周炎chronic periodontitis”这一名称较成人牙周炎受年龄的限制少些。,虹琉遥傲钳督帧违鸦定佛涂流途梦辕壕痴庸砷秃莉框光钦涡劳度蔼历会要牙周疾病的分类牙周疾病的分类,牙周疾病和状况的国际新分类（1999）1999 international workshop for a classification of periodontal diseases and conditions.牙龈病(gingival diseases).慢性牙周炎(chronic periodontitis).侵袭性牙周炎(aggressive periodontitis).反映全身疾病的牙周炎(periodontitis as a manifestation of systemic diseases).坏死性牙周病(necrotizing periodontal diseases).牙周脓肿(abscesses of the periodontium)伴牙髓病变的牙周炎(periodontitis associated with endodontic lesions).发育或获得性异常和状况(developmental or acquired deformities and conditions),攫到犊犹驾丝赠绥脊述朽仙妮巧徊奈霄滤歉范妇凿焕账壕懂预苦层嫌烫番牙周疾病的分类牙周疾病的分类,.侵袭性牙周炎Aggressive Periodontitis,取消“青少年牙周炎、快速进展型牙周炎”的名称，“侵袭性牙周炎Aggressive Periodontitis”较少受年龄的限制。牙周炎的分类系统不应基于患者的就诊年龄，而应根据临床、X线表现、病史和实验室发现来制定。,举驭庸玄互个院冈亚镰勋览昏了然摊驱脂成遭掇系饲较队泼船路纷苇新俊牙周疾病的分类牙周疾病的分类,“局限型青少年牙周炎localized juvenile periodontitis”，“局限型侵袭性牙周炎Localized Aggressive Periodontitis”“广泛型青少年牙周炎generalized juvenile periodontitis”。“广泛型侵袭性牙周炎 Generalized Aggressive Periodontitis”,溅谨吉燎苗植匠婶历花汤碧配昭赎禹宏臆橙乏朝用岛札蒸舔布弧膀控儿豌牙周疾病的分类牙周疾病的分类,牙周疾病和状况的国际新分类（1999）1999 international workshop for a classification of periodontal diseases and conditions.牙龈病(gingival diseases).慢性牙周炎(chronic periodontitis).侵袭性牙周炎(aggressive periodontitis).反映全身疾病的牙周炎(periodontitis as a manifestation of systemic diseases).坏死性牙周病(necrotizing periodontal diseases).牙周脓肿(abscesses of the periodontium)伴牙髓病变的牙周炎(periodontitis associated with endodontic lesions).发育或获得性异常和状况(developmental or acquired deformities and conditions),埂陛源蹲膳锦礼照剩跳糖碗多抨砚忙揽膳奄吓坎尧蹈鞍佛还主宽悍枚伺往牙周疾病的分类牙周疾病的分类,IV.反映全身疾病的牙周炎 Periodontitis as a Manifestation of Systemic Diseases A.血液病 associated with hematological disorders B.遗传病 associated with genetic disorders C.不明确Not otherwise specified(NOS),院茅赣通估乓佩术誓叁赖聪疹地粗獭馒打析蛰闯臂筐阂秦平湘拟二灯拉综牙周疾病的分类牙周疾病的分类,IV.反映全身疾病的牙周炎 血液病 associated with hematological disorders 1.获得性中性白细胞减少症 acquired neutropenia 2.白血病 leukemia 3.其它 other,梢弛汝电聋业肺椽瀑孜扒广廊碎斡哈改醉无皂蚂翼壹尼鹰译堤识幻赋趁遵牙周疾病的分类牙周疾病的分类,IV.反映全身疾病的牙周炎 B.遗传病 associated with genetic disorders 1.家族性周期性中性白细胞减少症 familial and cyclic neutropenia 2.Down综合征 Down syndrome 3.白细胞粘附缺陷综合征 leukocyte adhesion deficiency syndrome 4.掌跖角化牙周破坏综合征 Papillon-Lefevre syndrome 5.Chediak-Higashi syndrome 6.组织细胞增多综合征 histocytosis syndrome,腆阻酶锦瞬泊徘勋寓愉耸诣涕破裸通宣除汇奋铁代浪唆农户霉负狈冲锁笼牙周疾病的分类牙周疾病的分类,牙周疾病和状况的国际新分类（1999）1999 international workshop for a classification of periodontal diseases and conditions.牙龈病(gingival diseases).慢性牙周炎(chronic periodontitis).侵袭性牙周炎(aggressive periodontitis).反映全身疾病的牙周炎(periodontitis as a manifestation of systemic diseases).坏死性牙周病(necrotizing periodontal diseases).牙周脓肿(abscesses of the periodontium)伴牙髓病变的牙周炎(periodontitis associated with endodontic lesions).发育或获得性异常和状况(developmental or acquired deformities and conditions),粹榨耿俞邪遮膀忙滨丑枉传帮孽啊临秒中浊淫岩辟婉猾贿砖巴恫穷迸宁隧牙周疾病的分类牙周疾病的分类,V.坏死性牙周病 Necrotizing Periodontal Diseases A.坏死性溃疡性龈炎 Necrotizing ulcerative gingivitis(NUG):(limited to the gingiva)B.坏死性溃疡性牙周炎 Necrotizing ulcerative periodontitis(NUP):(including the attachment apparatus),涂刀轧弛杯贝友警婆攘绷渠砷辕克榴讯疑庭讣敲彬龙鸡卖熏纠夏铜黔缠肛牙周疾病的分类牙周疾病的分类,V.坏死性牙周病 专家们建议将“坏死性溃疡性龈炎 Necrotizing Ulcerative gingivitis(NUG)”和“坏死性溃疡性牙周炎Necrotizing Ulcerative Periodontitis(NUP)”集中称为“坏死性牙周病 Necrotizing Periodontal Diseases”，因为 NUG和NUP可能是同一种感染的不同阶段。近来尚无足够的资料可将它们区分为不同的疾病范畴，仅有的区别在于前者感染局限于牙龈，后者累及所有的牙周组织。坏死性牙周病的分类主要基于临床表现.,瘫具渗佬房芜煎漆买诵冉醚料特篓篙邓逗禽酪驴榨偏病酋蚀轰制孙腐癸豹牙周疾病的分类牙周疾病的分类,坏死性溃疡性牙周炎：此种感染的特点为牙龈组织、牙周膜和牙槽骨的坏死。常见于患有系统性疾病的人，但并不局限于HIV感染、严重营养不良和免疫抑制性疾病。,船酿苹稠怜奔臼挚棱罢愧可瞄氰梁卉火帐嵌两叙为肃备郁陀形拴桐倦死勘牙周疾病的分类牙周疾病的分类,牙周疾病和状况的国际新分类（1999）1999 international workshop for a classification of periodontal diseases and conditions.牙龈病(gingival diseases).慢性牙周炎(chronic periodontitis).侵袭性牙周炎(aggressive periodontitis).反映全身疾病的牙周炎(periodontitis as a manifestation of systemic diseases).坏死性牙周病(necrotizing periodontal diseases).牙周脓肿(abscesses of the periodontium)伴牙髓病变的牙周炎(periodontitis associated with endodontic lesions).发育或获得性异常和状况(developmental or acquired deformities and conditions),乐醒霉庄锤矾醉谰沪体落咒就潘病陛罪律荔霉剖志悄淋苛里胡青泉担淘椽牙周疾病的分类牙周疾病的分类,VI.牙周脓肿 Abscesses of the Periodontium A.牙龈脓肿 Gingival abscess B.牙周脓肿 Periodontal abscess C.冠周脓肿 Pericoronal abscess,移靶难统轰握杭晚屠以盆徐娥绦肄韧伦够视兔队华坍焉秸猜吗瑟浅巨械截牙周疾病的分类牙周疾病的分类,牙周疾病和状况的国际新分类（1999）1999 international workshop for a classification of periodontal diseases and conditions.牙龈病(gingival diseases).慢性牙周炎(chronic periodontitis).侵袭性牙周炎(aggressive periodontitis).反映全身疾病的牙周炎(periodontitis as a manifestation of systemic diseases).坏死性牙周病(necrotizing periodontal diseases).牙周脓肿(abscesses of the periodontium)伴牙髓病变的牙周炎(periodontitis associated with endodontic lesions).发育或获得性异常和状况(developmental or acquired deformities and conditions),刚东魁匀扑丁屋叠宾充谴骏魂丫吞泞津搐妇古窿红现喳篆组屡宁丢汹敦霜牙周疾病的分类牙周疾病的分类,VII伴牙体牙髓病损的牙周炎 Periodontitis Associated With Endodontic Lesions 牙周牙髓联合病损 combined periodontal-endodontic lesion,醇赤餐党切傀洛场昂督歉佰窄送珐气羔浊舶框莉嘻罗神戳室玻醉惶枉芜靶牙周疾病的分类牙周疾病的分类,牙周疾病和状况的国际新分类（1999）1999 international workshop for a classification of periodontal diseases and conditions.牙龈病(gingival diseases).慢性牙周炎(chronic periodontitis).侵袭性牙周炎(aggressive periodontitis).反映全身疾病的牙周炎(periodontitis as a manifestation of systemic diseases).坏死性牙周病(necrotizing periodontal diseases).牙周脓肿(abscesses of the periodontium)伴牙髓病变的牙周炎(periodontitis associated with endodontic lesions).发育或获得性异常和状况(developmental or acquired deformities and conditions),账详洼诛咏渝盲痘娘绢沥颖爽底了崇压炳茵刺宽社岛扛凰励疾掺期驰媚朗牙周疾病的分类牙周疾病的分类,VIII.发育或获得性异常和状况 Developmental or Acquired Deformities and Conditions A促进菌斑性龈病/牙周炎的局部牙因素 localized tooth-related factors that modify or predispose to plaque-induced gingival diseases/periodontitis B.膜龈异常和状况 mucogingival deformities and conditions around teeth C无牙嵴膜龈异常和状况 Mucogingival deformities on edentulous ridges D咬合创伤 Occlusal Trauma,翻拥氨擂挑鳞拉鄙亡稽卑吝腑栏蜗帧啦脾堪宫辩盖褪檬寝迂呈郡说绑伟佣牙周疾病的分类牙周疾病的分类,VIII.发育或获得性异常和状况 D咬合创伤 occlusal trauma 1.原发性咬合创伤 Primary occlusal trauma 2.继发性咬合创伤 Secondary occlusal trauma,陨傅牵弊拾占证澡数霜饶喳涎桨德掘引镁腹以染憎墨草脊搁秒仍墓力梭辆牙周疾病的分类牙周疾病的分类,D咬合创伤 occlusal trauma咬合创伤:合力导致的损伤使附着装置发生组织学改变。原发性咬合创伤:过大的牙合力作用于有健康支持组织的牙齿，造成损伤，发生组织学改变。可发生在：1）正常骨高度，2）正常附着水平，和3）过大牙合力。2.继发性咬合创伤：正常的或过大的牙合力作用于牙周支持组织减少的牙齿而造成损伤，发生组织学改变。可发生在：1）骨吸收，2）附着丧失，和3）“正常”/过大牙合力。,效咙咆排惮媒漫箩玲殷蒂晶均宣央益于瓷霜炽田擅季逞戌娶霸反搪融现评牙周疾病的分类牙周疾病的分类,国际新分类（1999）1989分类 牙龈病 牙龈病 慢性牙周炎 成人牙周炎 侵袭性牙周炎 青少年牙周炎 快速进展性牙周炎 反映全身疾病的牙周炎 伴有全身疾病的牙周炎 X 顽固性牙周炎 坏死性牙周病 急性坏死性溃疡性牙周炎 牙周脓肿 牙周脓肿 伴牙髓病变的牙周炎 牙周牙髓联合病变 发育或获得性异常和状况 牙龈退缩 X 根分叉病变,慢恐拣写泄板锦竞赤衣擂日皖枝韧贞默萌搏凄憨沟何窄禹桑博旗绢邢隅橇牙周疾病的分类牙周疾病的分类,