Practice: Periodontitis Staging and Grading (2017 Classification)
Case 1
A 42-year-old patient presents with mild bleeding on probing.
- Interdental CAL: 2 mm (at several sites)
- RBL: <15% (coronal third)
- Probing depth: 4 mm
- No tooth loss
- Non-smoker, normoglycemic
Q: What is the stage and grade?
✅ Answer: Stage I — Grade A.
Reason: CAL 1–2 mm, RBL <15%, no risk factors, slow progression.
Reason: CAL 1–2 mm, RBL <15%, no risk factors, slow progression.
Case 2
A 50-year-old non-smoker complains of occasional gum bleeding.
- Interdental CAL: 3–4 mm
- RBL: 20% (coronal third)
- Probing depth: ≤5 mm
- No tooth loss due to periodontitis
- HbA1c: 6.2%
Q: What is the stage and grade?
✅ Answer: Stage II — Grade B.
Reason: CAL 3–4 mm, RBL 15–33%, moderate progression, average risk profile.
Reason: CAL 3–4 mm, RBL 15–33%, moderate progression, average risk profile.
Case 3
A 45-year-old patient presents with tooth mobility and furcation involvement.
- Interdental CAL: 5 mm
- RBL: extending to middle third of root
- Tooth loss: 3 teeth due to periodontitis
- Probing depth: 6 mm
- Furcation Class II in molars
- Non-smoker, HbA1c: 6.8%
Q: What is the stage and grade?
✅ Answer: Stage III — Grade B.
Reason: CAL ≥5 mm, RBL to middle third, ≤4 teeth lost, furcation involvement; no high-risk modifiers.
Reason: CAL ≥5 mm, RBL to middle third, ≤4 teeth lost, furcation involvement; no high-risk modifiers.
Case 4
A 55-year-old heavy smoker (>10 cigarettes/day) with diabetes (HbA1c = 8.0%).
- CAL: ≥5 mm in several teeth
- RBL: beyond middle third of root
- Tooth loss: 5 teeth due to periodontitis
- Probing depth: 6–7 mm
- Masticatory dysfunction present
Q: What is the stage and grade?
✅ Answer: Stage IV — Grade C.
Reason: Severe destruction (≥5 teeth lost), masticatory dysfunction, heavy smoking and uncontrolled diabetes.
Reason: Severe destruction (≥5 teeth lost), masticatory dysfunction, heavy smoking and uncontrolled diabetes.
Case 5
A 28-year-old patient with severe bone loss around molars and incisors but minimal plaque.
- Interdental CAL: 5 mm
- RBL: extending to middle third of root
- Pattern: molar–incisor
- Non-smoker, no systemic disease
- Family history of early tooth loss
Q: What is the stage and grade?
✅ Answer: Stage III — Grade C.
Reason: Severe localized (molar–incisor) pattern in a young patient, rapid progression, familial tendency.
Reason: Severe localized (molar–incisor) pattern in a young patient, rapid progression, familial tendency.
Case 6
A 40-year-old patient with moderate bone loss and mobility.
- CAL: 4 mm
- RBL: 30% (coronal third)
- Tooth loss: 2 teeth due to periodontitis
- Smoker: 5 cigarettes/day
- HbA1c: 5.9%
Q: What is the stage and grade?
✅ Answer: Stage III — Grade B.
Reason: CAL ~4 mm with tooth loss, moderate complexity; light smoker (≤10/day) fits Grade B.
Reason: CAL ~4 mm with tooth loss, moderate complexity; light smoker (≤10/day) fits Grade B.
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