单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,医学课件园 yxkjy,*,牙周疾病的分类,（Classification of Periodontal Diseases）,11/11/2024,医学课件园 yxkjy,牙周疾病的分类 医学课件园 yxkjy,1,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医学课件园 yxkjy,牙周疾病的分类 医学课件园 yxkjy,2,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),医学课件园 yxkjy,Gottlieb分类,3,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,医学课件园 yxkjy,4,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),医学课件园 yxkjy,Page&Schroeder 分类(1982,5,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),医学课件园 yxkjy,牙,6,（,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医学课件园 yxkjy,（1989）分类 的不足：医学课件园 yxkjy,7,牙周疾病和状况的国际新分类（2019）,2019 international workshop for a classification of,periodontal diseases and conditions,.牙龈病 (g,ingival 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),医学课件园 yxkjy,牙周疾病和状况的国际新分类（2019）,8,牙周疾病和状况的国际新分类（2019）,2019 international workshop for a classification of,periodontal diseases and conditions,.牙龈病 (g,ingival diseases,),.慢性牙周炎 (c,hronic 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),医学课件园 yxkjy,牙周疾病和状况的国际新分类（2019）,9,.,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医学课件园 yxkjy,.慢性牙周炎 Chronic Periodontitis,10,牙周疾病和状况的国际新分类（2019）,2019 international workshop for a classification of,periodontal diseases and conditions,.,牙龈病 (g,ingival 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),医学课件园 yxkjy,牙周疾病和状况的国际新分类（2019）,11,.,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医学课件园 yxkjy,.侵袭性牙周炎Aggressive Periodonti,12,“,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,”,医学课件园 yxkjy,“局限型青少年牙周炎localized juvenile p,13,牙周疾病和状况的国际新分类（2019）,2019 international workshop for a classification of,periodontal diseases and conditions,.牙龈病 (g,ingival diseases,).慢性牙周炎 (c,hronic 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),医学课件园 yxkjy,牙周疾病和状况的国际新分类（2019）,14,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),医学课件园 yxkjy,IV.反映全身疾病的牙周,15,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,医学课件园 yxkjy,IV.反映全身疾病的牙,16,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,医学课件园 yxkjy,IV.反映全身疾病的牙周炎 医学课件园,17,牙周疾病和状况的国际新分类（2019）,2019 international workshop for a classifi。
