Review Article

Chronic Periodontitis Case Definitions and Confounders in Periodontal Research: A Systematic Assessment

Table 3

Frequency and percentage of chronic periodontitis severity case definitions.

Definition of severity Studies # (%)

Severe
CAL:
at least 1 site CAL≥62(2.1)
at least 2 teeth CAL ≥6 mm1(1.1)
at least 2 sites CAL≥41(1.1)
at least 30% sites CAL≥53(3.2)
CAL ≥ 6 mm2(2.1)
CAL ≥5 mm15(16.0)
Radiograph:
>50 % of the root4(4.3)
>33% of the roots, or if angular bony defects/furcation defects degree II and III in more than 3 teeth (molar and premolar regions)1(1.1)
PD:
PD≥6 mm4(4.3)
PD of ≥4 mm and at least 10 sites of PD ≥6 mm.1(1.1)
≥19 sites PD ≥5 mm1(1.1)
PD 7 to 8 mm1(1.1)
PD > 7.5 mm1(1.1)
PD ≥41(1.1)
at least 10% of sites with PD≥ 6 mm (moderate to severe )1(1.1)
PD + CAL:
PD and CAL ≥5 mm1(1.1)
PD≥4 and CAL≥61(1.1)
PD≥5 and CAL≥62(2.1)
PD ≥5 and CAL≥4 (moderate or severe)42(44.7)
at least two sites CAL ≥ 6mm (not on same tooth) and at least one site with PD ≥5mm1(1.1)
PD≥6 and CAL≥51(1.1)
PD and CAL ≥5mm2(2.1)
PD and CAL≥6 mm1(1.1)
CAL or PD with radiograph:
PD≥5 and radiographic panorama ≥301(1.1)
CAL >6 mm, grade II and/or III furcation, possible tooth mobility class II or III1(1.1)
PD + CAL+ BOP:
PD≥5, CAL≥6 and BOP1(1.1)
PD≥5, CAL≥6 BOP≥301(1.1)
 Total94(100)
Moderate
CAL:
CAL 3–4 mm15(42.9)
CAL 3 to 6 mm CAL1(2.9)
3 sites with CAL ≥4 mm1(2.9)
Radiograph:
20-30% of the root1(2.9)
>2 mm not exceeding one-third of the roots, or if angular bony defects/furcation defects degree II and III in 2-3 teeth (molar and premolar regions)1(2.9)
PD:
PD 4-5 mm1(2.9)
PD with ≥4 mm and a maximum of 9 sites with PPD of ≥6 mm1(2.9)
≥7 to 18 sites PD ≥5 mm1(2.9)
PD ≥31(2.9)
PD 5.5 and 7.5 mm1(2.9)
PD 5 to 8mm1(2.9)
PD + CAL:
PD≥4 and CAL≥41(2.9)
PD ≥5 and CAL≥41(2.9)
PD >5 mm and CAL = 3–4 mm1(2.9)
PD and CAL≥3 and <5mm2(5.7)
PD≥4 and CAL≥4 mm1(2.9)
at least one site with both ≥ 4 mm and PD of ≥4 mm1(2.9)
CAL or PD with radiograph:
CAL 4–6 mm, grade I and/or II furcation, and possible tooth mobility class I1(2.9)
PD + CAL+ BOP
PD≥5, CAL≥4 and BOP1(2.9)
PD≥5, CAL≥3 and BOP≥301(2.9)
 Total35(100)
Mild
CAL:
CAL 4–5 mm1(4.0)
at least 2 teeth CAL ≥1 mm1(4.0)
at least at one site CAL < 3 mm1(4.0)
CAL of 1–2 mm15(60.0)
PD:
mild or no disease with PPD of ≤4 mm1(4.0)
≥3 to 6 sites that are PD ≥5 mm1(4.0)
PD 4 to 5mm1(4.0)
PD 3.5 and 5.5 mm1(4.0)
at least 10% of sites with PD of 5 mm1(4.0)
PD + CAL
PD > 5 mm and CAL = 1–21(4.0)
CAL or PD with radiograph
CAL ≤4 mm and possible class I furcation invasion areas1(4.0)
 Total25(100)

CAL: clinical attachment level, PD: probing depth, and BOP: bleeding on probing.