{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T02:08:03Z","timestamp":1792030083164,"version":"4.4.0"},"reference-count":44,"publisher":"Wiley","issue":"S20","license":[{"start":{"date-parts":[[2018,6,20]],"date-time":"2018-06-20T00:00:00Z","timestamp":1529452800000},"content-version":"vor","delay-in-days":19,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100005342","name":"American Academy of Periodontology Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100005342","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004368","name":"Colgate-Palmolive Company","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004368","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004331","name":"Johnson and Johnson","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004331","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004357","name":"Procter and Gamble","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004357","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Clinic Periodontology"],"published-print":{"date-parts":[[2018,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>A variety of systemic diseases and conditions can affect the course of periodontitis or have a negative impact on the periodontal attachment apparatus. Gingival recessions are highly prevalent and often associated with hypersensitivity, the development of caries and non\u2010carious cervical lesions on the exposed root surface and impaired esthetics. Occlusal forces can result in injury of teeth and periodontal attachment apparatus. Several developmental or acquired conditions associated with teeth or prostheses may predispose to diseases of the periodontium. The aim of this working group was to review and update the 1999 classification with regard to these diseases and conditions, and to develop case definitions and diagnostic considerations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Discussions were informed by four reviews on 1) periodontal manifestions of systemic diseases and conditions; 2) mucogingival conditions around natural teeth; 3) traumatic occlusal forces and occlusal trauma; and 4) dental prostheses and tooth related factors. This consensus report is based on the results of these reviews and on expert opinion of the participants.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Key findings included the following: 1) there are mainly rare systemic conditions (such as Papillon\u2010Lefevre Syndrome, leucocyte adhesion deficiency, and others) with a major effect on the course of periodontitis and more common conditions (such as diabetes mellitus) with variable effects, as well as conditions affecting the periodontal apparatus independently of dental plaque biofilm\u2010induced inflammation (such as neoplastic diseases); 2) diabetes\u2010associated periodontitis should not be regarded as a distinct diagnosis, but diabetes should be recognized as an important modifying factor and included in a clinical diagnosis of periodontitis as a descriptor; 3) likewise, tobacco smoking \u2013 now considered a dependence to nicotine and a chronic relapsing medical disorder with major adverse effects on the periodontal supporting tissues \u2013 is an important modifier to be included in a clinical diagnosis of periodontitis as a descriptor; 4) the importance of the gingival phenotype, encompassing gingival thickness and width in the context of mucogingival conditions, is recognized and a novel classification for gingival recessions is introduced; 5) there is no evidence that traumatic occlusal forces lead to periodontal attachment loss, non\u2010carious cervical lesions, or gingival recessions; 6) traumatic occlusal forces lead to adaptive mobility in teeth with normal support, whereas they lead to progressive mobility in teeth with reduced support, usually requiring splinting; 7) the term\n                      <jats:italic>biologic width<\/jats:italic>\n                      is replaced by\n                      <jats:italic>supracrestal tissue attachment<\/jats:italic>\n                      consisting of junctional epithelium and supracrestal connective tissue; 8) infringement of restorative margins within the supracrestal connective tissue attachment is associated with inflammation and\/or loss of periodontal supporting tissue. However, it is not evident whether the negative effects on the periodontium are caused by dental plaque biofilm, trauma, toxicity of dental materials or a combination of these factors; 9) tooth anatomical factors are related to dental plaque biofilm\u2010induced gingival inflammation and loss of periodontal supporting tissues.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>An updated classification of the periodontal manifestations and conditions affecting the course of periodontitis and the periodontal attachment apparatus, as well as of developmental and acquired conditions, is introduced. Case definitions and diagnostic considerations are also presented.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jcpe.12951","type":"journal-article","created":{"date-parts":[[2018,6,21]],"date-time":"2018-06-21T04:45:40Z","timestamp":1529556340000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":326,"title":["Periodontal manifestations of systemic diseases and developmental and acquired conditions: Consensus report of workgroup 3 of the 2017 World Workshop on the Classification of Periodontal and Peri\u2010Implant Diseases and Conditions"],"prefix":"10.1111","volume":"45","author":[{"given":"S\u00f8ren","family":"Jepsen","sequence":"first","affiliation":[{"name":"Department of Periodontology Operative and Preventive Dentistry University of Bonn  Bonn Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jack G.","family":"Caton","sequence":"additional","affiliation":[{"name":"University of Rochester Periodontics, Eastman Institute for Oral Health  Rochester NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jasim M.","family":"Albandar","sequence":"additional","affiliation":[{"name":"Department of Periodontology and Oral Implantology Temple University School of Dentistry  Philadelphia PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nabil F.","family":"Bissada","sequence":"additional","affiliation":[{"name":"Case Western Reserve University  Cleveland OH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philippe","family":"Bouchard","sequence":"additional","affiliation":[{"name":"U.F.R. d'Odontologie Universit\u00e9 Paris Diderot  H\u00f4pital Rothschild AP\u2010HP Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierpaolo","family":"Cortellini","sequence":"additional","affiliation":[{"name":"Private practice, Firenze, Italy; 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