journal article Open Access Feb 27, 2025

Periodontitis: Grade Modifiers Revisited

Oral Diseases Vol. 31 No. 6 pp. 1637-1646 · Wiley
View at Publisher Save 10.1111/odi.15297
Abstract
ABSTRACT

Objective
This review aimed to propose new grade modifiers for the risk assessment of periodontitis.


Materials and Methods
Literature on the known risk factors, current, and potential grade modifiers was reviewed.


Results
The transition to a staging and grading system for periodontitis was driven by the need for consistent and comprehensive classification that facilitates diagnosis and personalized treatment planning. The new system assesses severity and complexity based on clinical attachment loss, radiographic bone loss, and patient history, and integrates risk factors into the grading scheme as grade modifiers. The two commonly used grade modifiers are smoking and diabetes mellitus. The changes to grade B or C are based on the number of cigarettes smoked per day and the level of glycemic levels, which are known thresholds used in association studies of risk factors for periodontitis. New grade modifiers such as systemic inflammatory response, rheumatoid arthritis, osteoporosis, obesity, and neurodegenerative disease were identified.


Conclusion
While adding grade modifiers may increase complexity, they could improve the prognostic accuracy of the current classification, enabling more precise assessment, personalized treatment, and better management of periodontitis, especially in patients with systemic risk factors.
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Details
Published
Feb 27, 2025
Vol/Issue
31(6)
Pages
1637-1646
License
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Cite This Article
Obada Saleh, Anas Abdulmunim, Ibrahim Aboushakra, et al. (2025). Periodontitis: Grade Modifiers Revisited. Oral Diseases, 31(6), 1637-1646. https://doi.org/10.1111/odi.15297