Changing concepts in Periodontitis
Classifications essentially provide a basis regarding etiology, risk assesment, pathogenesis and treatment of diseases, also group similar disease phenotypes as homogeneous syndromes, and enable clinicians to understand and manage diaseases according to patients’ needs. Updating of classifications based on new scientific evidence and technological advances is a natural process. It can easily be noticed that the updated classification entitled “Periodontal and periimplant diseases and conditions”, is the outcome of such a process and, in general, the new context has a rather different approach with the potential to have an impact on scientific and epidemilogical studies and also on clinical practice. This new classification is suggested to highlight evidence, provide a rationale and easy application for daily clinical practice, and overcome the clinical challenges of practitioners (E.g. uncertainities in differential diagnosis of cases with clear overlaps in diagnostic criteria). Likewise all new classifications, a comprehensive analysis of the classification based on context, rationale and approach has the potential to provide benefits both for scientific and epidemilogical studies and for clinical practice. Thus, parameters for diagnosis and progression of periodontitis, benefit of risk assesment and modifiable risk factors, the contribution of a better understanding of the interaction of biofilm, host defence and destruction patterns for the pathogenesis and diagnosis, and the modern idea together with new paradigms or paradigm shifts that are associated with the new classification are naturally of crucial importance. Only with such an approach it may be possible to effectively treat patients via the most appropriate individual treatment approach.