Periodontal Management of Cyclosporin A-Induced Gingival Overgrowth: A Nonsurgical Approach

Table 2

Periodontitis grade according to the 2018 new classification.

Periodontitis grade			Grade A: slow rate of progression	Grade B: moderate rate of progression	Grade C: rapid rate of progression
Primary criteria	Direct evidence of progression	Longitudinal data (radiographic bone loss or CAL)	Evidence of no loss over 5 years	<2 mm over 5 years	>2 mm over 5 years
	Indirect evidence of progression	% bone loss/age	<0.25	0.25 to 1.0	>1.0
		Case phenotype	Heavy biofilm deposits with low levels of destruction	Destruction commensurate with biofilm deposits	Destruction exceeds expectation given biofilm deposits; specific clinical patterns suggestive of periods of rapid progression and/or early onset of disease, e.g., molar/ incisor pattern; lack of expected response of standard bacterial control therapies
Grade modifiers	Risk factors	Smoking	Nonsmoker	cigarettes/day	cigarettes/day
		Diabetes	Normoglycemic/no diagnosis of diabetes	in patients with diabetes	in patients with diabetes
Risk of systemic impact of periodontitis	Inflammatory burden	High-sensitivity CRP (hs CRP)	<1 mg/L	1-3 mg/L	>3 mg/L
Biomarkers	Indicators of CAL/bone loss	Saliva, gingival crevicular fluid, and serum	?	?	?