口腔医学牙周病学ppt课件牙周疾病的分类

牙周疾病的分类（CLASSIFICATIONOFPERIODONTALDISEASES）20111291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。2GOTTLIEB分类1928炎症性不洁性脓漏（SCHMUTZPYORRHEA）由口腔卫生不良所致变性或萎缩弥漫性牙槽萎缩（DIFFUSEALVEOLARATROPHY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（PARADENTALPYORRHEA3ORBAN分类（1949）炎症状态INFLAMMATORYCONDITIONS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DEGENERATIVECONDITIONS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ATROPHICCONDITIONS牙周萎缩牙周创伤PERIODONTALTRAUMATISM原发性继发性牙龈增生GINGIVALHYPERPLASIA感染内分泌失调药物性特发性4PAGESCHROEDER分类1982I青春前期牙周炎PREPUBERTALPERIODONTITISPPP弥漫型局限型II青少年牙周炎JUVENILEPERIODONTITISJPIII快速进展性牙周RAPIDLYPROGRESIVEPERIODONTITISRPPIV成人牙周炎ADULTPERIODONTITISAP5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（ADULTPERIODONTITISAP）II早发性牙周炎EARLYONSETPERIODONTITISEOP青春前期PREPUBERTALPERIODONTITISPPP局限型或广泛型青少年JUVENILEPERIODONTITISJP局限型或广泛型快速进展性（RAPIDLYPROGRESSIVEPERIODONTITISRPP）III伴有全身疾病的牙周炎（PERIODONTITISASSOCIATEDWITHSYSTEMICDISEASES）IV坏死溃疡性牙周炎（NECROTIZINGULCERATIVEPERIODONTITIS）V顽固性牙周炎REFRACTORYPERIODONTITIS6（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。7牙周疾病和状况的国际新分类（1999）1999INTERNATIONALWORKSHOPFORACLASSIFICATIONOFPERIODONTALDISEASESANDCONDITIONS牙龈病GINGIVALDISEASES慢性牙周炎CHRONICPERIODONTITIS侵袭性牙周炎AGGRESSIVEPERIODONTITIS反映全身疾病的牙周炎PERIODONTITISASAMANIFESTATIONOFSYSTEMICDISEASES坏死性牙周病NECROTIZINGPERIODONTALDISEASES牙周脓肿ABSCESSESOFTHEPERIODONTIUM伴牙髓病变的牙周炎PERIODONTITISASSOCIATEDWITHENDODONTICLESIONS发育或获得性异常和状况DEVELOPMENTALORACQUIREDDEFORMITIESANDCONDITIONS8牙周疾病和状况的国际新分类（1999）1999INTERNATIONALWORKSHOPFORACLASSIFICATIONOFPERIODONTALDISEASESANDCONDITIONS牙龈病GINGIVALDISEASES慢性牙周炎CHRONICPERIODONTITIS侵袭性牙周炎AGGRESSIVEPERIODONTITIS反映全身疾病的牙周炎PERIODONTITISASAMANIFESTATIONOFSYSTEMICDISEASES坏死性牙周病NECROTIZINGPERIODONTALDISEASES牙周脓肿ABSCESSESOFTHEPERIODONTIUM伴牙髓病变的牙周炎PERIODONTITISASSOCIATEDWITHENDODONTICLESIONS发育或获得性异常和状况DEVELOPMENTALORACQUIREDDEFORMITIESANDCONDITIONS9慢性牙周炎CHRONICPERIODONTITIS成人牙周炎ADULTPERIODONTITIS取消“成人牙周炎ADULTPERIODONTITIS”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CHRONICPERIODONTITIS”这一名称较成人牙周炎受年龄的限制少些。10牙周疾病和状况的国际新分类（1999）1999INTERNATIONALWORKSHOPFORACLASSIFICATIONOFPERIODONTALDISEASESANDCONDITIONS牙龈病GINGIVALDISEASES慢性牙周炎CHRONICPERIODONTITIS侵袭性牙周炎AGGRESSIVEPERIODONTITIS反映全身疾病的牙周炎PERIODONTITISASAMANIFESTATIONOFSYSTEMICDISEASES坏死性牙周病NECROTIZINGPERIODONTALDISEASES牙周脓肿ABSCESSESOFTHEPERIODONTIUM伴牙髓病变的牙周炎PERIODONTITISASSOCIATEDWITHENDODONTICLESIONS发育或获得性异常和状况DEVELOPMENTALORACQUIREDDEFORMITIESANDCONDITIONS11侵袭性牙周炎AGGRESSIVEPERIODONTITIS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AGGRESSIVEPERIODONTITIS”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。12“局限型青少年牙周炎LOCALIZEDJUVENILEPERIODONTITIS”，“局限型侵袭性牙周炎LOCALIZEDAGGRESSIVEPERIODONTITIS”“广泛型青少年牙周炎GENERALIZEDJUVENILEPERIODONTITIS”。“广泛型侵袭性牙周炎GENERALIZEDAGGRESSIVEPERIODONTITIS”13牙周疾病和状况的国际新分类（1999）1999INTERNATIONALWORKSHOPFORACLASSIFICATIONOFPERIODONTALDISEASESANDCONDITIONS牙龈病GINGIVALDISEASES慢性牙周炎CHRONICPERIODONTITIS侵袭性牙周炎AGGRESSIVEPERIODONTITIS反映全身疾病的牙周炎PERIODONTITISASAMANIFESTATIONOFSYSTEMICDISEASES坏死性牙周病NECROTIZINGPERIODONTALDISEASES牙周脓肿ABSCESSESOFTHEPERIODONTIUM伴牙髓病变的牙周炎PERIODONTITISASSOCIATEDWITHENDODONTICLESIONS发育或获得性异常和状况DEVELOPMENTALORACQUIREDDEFORMITIESANDCONDITIONS14IV反映全身疾病的牙周炎PERIODONTITISASAMANIFESTATIONOFSYSTEMICDISEASESA血液ASSOCIATEDWITHHEMATOLOGICALDISORDERSB遗传病ASSOCIATEDWITHGENETICDISORDERSC不明确NOTOTHERWISESPECIFIEDNOS15IV反映全身疾病的牙周炎A血液病ASSOCIATEDWITHHEMATOLOGICALDISORDERS1获得性中性白细胞减少症ACQUIREDNEUTROPENIA2白血病LEUKEMIA3其它OTHER16IV反映全身疾病的牙周炎B遗传病ASSOCIATEDWITHGENETICDISORDERS1家族性周期性中性白细胞减少症FAMILIALANDCYCLICNEUTROPENIA2DOWN综合征DOWNSYNDROME3白细胞粘附缺陷综合征LEUKOCYTEADHESIONDEFICIENCYSYNDROME4掌跖角化牙周破坏综合征PAPILLONLEFEVRESYNDROME5CHEDIAKHIGASHISYNDROME6组织细胞增多综合征HISTOCYTOSISSYNDROME17牙周疾病和状况的国际新分类（1999）1999INTERNATIONALWORKSHOPFORACLASSIFICATIONOFPERIODONTALDISEASESANDCONDITIONS牙龈病GINGIVALDISEASES慢性牙周炎CHRONICPERIODONTITIS侵袭性牙周炎AGGRESSIVEPERIODONTITIS反映全身疾病的牙周炎PERIODONTITISASAMANIFESTATIONOFSYSTEMICDISEASES坏死性牙周病NECROTIZINGPERIODONTALDISEASES牙周脓肿ABSCESSESOFTHEPERIODONTIUM伴牙髓病变的牙周炎PERIODONTITISASSOCIATEDWITHENDODONTICLESIONS发育或获得性异常和状况DEVELOPMENTALORACQUIREDDEFORMITIESANDCONDITIONS18V坏死性牙周病NECROTIZINGPERIODONTALDISEASESA坏死性溃疡性龈炎NECROTIZINGULCERATIVEGINGIVITISNUGLIMITEDTOTHEGINGIVAB坏死性溃疡性牙周炎NECROTIZINGULCERATIVEPERIODONTITISNUPINCLUDINGTHEATTACHMENTAPPARATUS19V坏死性牙周病专家们建议将“坏死性