Thank you so much for this video! I have no previous background in dental health but I wanted to learn more after a loved one was diagnosed with periodontal disease. I really appreciate your clear explanations and your work to make this knowledge more accessible.
Dr Ryan, you made this seemingly complex and technical concept absolutely enjoyable and understandable, and I appreciate that. Thousands of internationally trained dentists also appreciate your efforts. God bless you!
Hi, Ryan. As an associate professor of periodontics in her hometown and someone who is studying for the exam to become a dentist in her current country, I would like to state that I learned a lot from your videos and you explain periodontics really well. Thank you!
Dr.Ryan!you are genius of explanation.I was struggling with understanding perio classification.I couldn’t resolve in clinical situations.But with your explanations I cracked this hard nut.Thank you very very much.
I just wanted to write this incase someone needed some reassurance I watched the videos and did the questions on the app and passed the exam 🙏🏻 thanks Dr.Rayan!
Hello Dr Ryan. I believe you provided all with best resources to complete and pass the test. I would not had completed it without your help. Thank you very much.
Thank you so much for the wonderful presentation! I have learned a lot from watching this video. Will definitely help in my current role. Thousands like!
The second case Diagnosis is wrong. And i didnt watcg then further. Its generelised not localised. Coz u have CAL (2-3) all over that means its generelised but yes the staging will be decided from 8 mm CAL (even on one tooth)
This was very very helpful, thank you so much for making the effort to educate and share. There is just so many factors and I'm really struggling to pull it all together so I will be able to stage and grade without taking up half the appointment!
Thanks Again Ryan for making the concept easy and thanks for adding cases so that we can practice and get perfect.please make videos for dental anatomy.
Nicely done .Please make some videos on clinical cases NBDE part 2 which comes in board exams . How to interprete the clinical cases and their diagnosis most importantly the radiograph . Thanks
Hey Ryan! I can't thank you enough for your videos and massive contribution to the dental community. I do have a question regarding Case #4, I noticed that vertical bone loss was also present on tooth #13. However, you classified this as a Molar-Incisor pattern. I personally thought that it would be a Localized case given the affected premolar in this case. What do you think?
Good question! I arrived at the molar-incisor diagnosis because the vast, vast majority of the disease process is localized around the molars and incisors. Yes, there is some bone loss around #13 that is definitely noteworthy, but the pattern is clearly affecting the incisors and molars more than everything else.
Hi Dr. Ryan! Thank you so much for your helpful videos.🙏 Just wondering for Case #2 why do we count the 8mm CAL on the distal of tooth #3 as an interdental CAL when there’s no neighbouring tooth? In other words does interdental CAL not have to be between 2teeth?
Hello First of all thank you for your great effort I have a question regarding the furcation involvement You have said that furcation involvement Type 2 represents stage 3 While furcation involvement type 3 which is through and through represents stage 4 But if you look at the staging table in stage 3 both furcations type 2 and type 3 are there If you can clarify this point I’ll be very thankful Sorry if my English wasn’t that good
Thank you so much Dr.Ryan,i would also like to ask the following questions: -how would the therapy plan designed according to the stages?For example, stage 3 grade B or C ?( previously,the therapy would be designed according to the chronic or the aggressive periodontitis) -in the „radiological Interpretation” video,i hoped that you would incorporate the new classification,and so here, i would like to ask ,how would you suggest differential Diagnoses according to the new classification? For instance, could we describe (stage 3 Grade C , and Stage 4 Garde B) as separate differential diagnoses? -as an example, A.A. Bacteria was directly related(but not deciding ) to aggressive periodontitis, how is it co-related to periodontitis according to the new classification? Your efforts are much appreciated
The higher the stage and grade, the more strict maintenance that patient requires and the more likely they will need surgical treatment. Periodontists will typically give antibiotics for more “aggressive” cases (by that I mean Grade C), but they do this after scaling and root planing is completed for all four quadrants. Regardless of stage and grade though, plaque control is the most important component of periodontal therapy.
Hello Doctor. Thank you so much for this video. I have a question regarding case number two concerning the localized diagnosis. I understand that you diagnosed it as localized because the most severe CAL affected only a small number of teeth. But what about the remaining teeth ? All other teeth have CAL as well right?
asides from watching all of dr ryans videos and solving sample papers, what else should i use to study? and how much prep is covered by just dr ryans vids?
I definitely think my videos are the highest yield resource you can use to study. I also recommend using the Boards Mastery App for practice questions and getting the Mosby’s book that I link to in my video descriptions for studying and additional practice questions. Check out my Patreon page for more details. Best of luck to you!
I think Case # 2 is Grade B. The patient is already Stage III, which means there was already more than 30% bone loss. CAL of 8mm is already approx. half of the average root length. Assuming 50% bone loss, 50/70=0.7. Then after applying the grade modifiers (diabetes and smoking), there should be No change in grade.
Hello Dr Ryan. I hope you are doing great. You have made a very concise and precise video for us. Thanks alot. Secondly is this new classification included in NBDE Part 2 Exam? Thank you.
Hey Ryan! Could you please explain how progressive bone loss is evaluated for peri-implantitis, and how it differentiates from increased PD compared to baseline?
Thank you so much for the excellent video. I had a question. For Case #4 I see the premolars on the left side have significant bone loss yet it's described as Molar Incissor Pattern. Could someone please explain this?
Hi dr Ryan, thanks for incredible videos. How can I find explanation for the chart in case 2 . Unfortunately I’m not that much familiar to the numbers and their locations in the dental arch.
You rock. You explained this wonderful. Question about grading - How can we grade if we have no info for the last 5 years? (For example: new patient, and/or patient that has no access to their dental charts)?
@pegahqasemi8363 exactly ! The indirect evidence of progression . The % bone loss / age is a comprision between nominal and actual bone lost in percentage . Heavy biofilm deposits with low leveles of destruction means the host has healthy immune system and the progression is low . Now I need to learn this in German.
we were taught at dental school that the list is inclusive not exclusive. ie. that if a patient smokes more than 10 cigarettes a day they are automatically a grade C, no matter how stable they are which makes the classification system flawed.
Unfortunately, for lack of a better way of saying it, you were taught incorrectly. Here's a direct quote from the AAP: "Only one grade is assigned to the patient. It is based on either direct or indirect evidence of the rate of disease progression and risk for future progression. Other risk factors or grade modifiers such as smoking and diabetes mellitus may also be considered for their contribution to the rate of disease progression in the present or the future. For example, a patient with a Grade B rate of progression does NOT have to automatically become a C if his/her HbA1c is 7.2%, if in the judgment of the clinician the progression of the disease is not significantly impacted by this level of diabetes control. However, if the HbA1c is 9%, the impact on future attachment loss and response to therapy may be greater, which would prompt the clinician to assign a grade of C. The same reasoning may be applied to a patient who smokes more than 10 cigarettes per day. The question to be asked is, 'What impact has the patient’s smoking habit had on the current amount of attachment loss and on future loss of attachment or response to therapy?'" In other words, just because someone smokes 11 cigarettes a day doesn't automatically give them Grade C. As you said that makes no sense! If there is
Awesome video! One question however, for the "Peri-Implant Disease and Conditions" section of the new classification, how important is the "Peri-Implant Soft and Hard Tissue Deficiencies" subsection?
That section is relatively unimportant for the board exam. If you're curious, that category under "Peri-Implant Diseases and Conditions" refers to defects in soft and hard tissues that are present PRIOR to implant placement which may be linked to a poor outcome of the implant.
why is case 4 Molar Incisor as it appears the premolars are affected on the LHS bitewing? But good to know that its not all the molar and incisor teeth affected that would classify it as molar incisor periodontitis
Why is the interdental CAL more critical and the one that is used for grading severity? Why is a non-interdental deep pocket of 10mm not as significant?
Why case II is localised ? Aren’t all of the examined teeth have CAL , Or we consider only the ones that go along with staging , like if we’re on stage III we only include teeth that have >=5 mm ID CAL ? Like that?
Great video but I disagree with u on case 3 it shows a generalized pattern and an RBL >50% around upper incisors so it should be generalized stage 3 grade c
Thanks for watching! For more high yield dental content, subscribe to Mental Dental today: ua-cam.com/users/mentaldental
You are something else.
I passed INBDE and Dr. Ryan was the biggest reason why! Thanks @mentaldental !
what were some study materials that you used!? please let me know!
Hey, did u use any other resources? if yes what? ty
Thank you so much for this video! I have no previous background in dental health but I wanted to learn more after a loved one was diagnosed with periodontal disease. I really appreciate your clear explanations and your work to make this knowledge more accessible.
Dr Ryan, you made this seemingly complex and technical concept absolutely enjoyable and understandable, and I appreciate that. Thousands of internationally trained dentists also appreciate your efforts. God bless you!
I’m so glad it was helpful! You’re welcome, and God bless you! 🙌🏼🙏🏼
Hi, Ryan. As an associate professor of periodontics in her hometown and someone who is studying for the exam to become a dentist in her current country, I would like to state that I learned a lot from your videos and you explain periodontics really well. Thank you!
Thank you so much for your positive feedback! 😊🙏🏼
Phenomenal teacher !!!
Best in the whole world !!!
This 2018 things will go into head with repetition !!!
Dr.Ryan!you are genius of explanation.I was struggling with understanding perio classification.I couldn’t resolve in clinical situations.But with your explanations I cracked this hard nut.Thank you very very much.
Glad it was helpful!
I just wanted to write this incase someone needed some reassurance I watched the videos and did the questions on the app and passed the exam 🙏🏻 thanks Dr.Rayan!
Way to go!! Congratulations! 🎉🤩🙌🏼
I can't thank you enough for your videos. They have really helped me in understanding so many topics that seemed tough.
Thank you
Great to hear! Thank you for the kind words! 🙏🏼
hey Dr. Ryan . i am preparing for NDEB AFK canadian equivalency exam and your videos are so helpful to understand basics n concepts.. thanx a lot.
Thank you so much Dr.
was a great brief lecture. Could not be enough simpler than this.
Thank you so much Dr Ryan!! 🥺🥺✨
I passed SDLE test and Dr. Ryan was the biggest reason Thank you very much @mentaldental
You are so welcome! Congratulations 🤩🎊
Hello Dr Ryan. I believe you provided all with best resources to complete and pass the test. I would not had completed it without your help. Thank you very much.
I am so glad to hear that! 🙌🏼
Great work sir...got addicted to your classes.
Thank you
thanks a lot Ryan..., specially for the case discussion in this video, things are much clearer now.. God bless you..
Glad it was helpful! 😊🙏🏼
Very simplified version of new classification... Thanks
Thank you so much for the wonderful presentation! I have learned a lot from watching this video. Will definitely help in my current role. Thousands like!
That is so great to hear! Really glad you enjoyed it! 😊
It was amazing finally I could understand classification. Thanks a million
Dr Ryan is wonderful inspiring has clarity and is inspiring me toward excellence. I am just a Hygienist. Thank you Dr. ryan
Glad you enjoyed it!
this clinical case discussion was really good. gave good insight about the exam. thanks.
The second case Diagnosis is wrong.
And i didnt watcg then further.
Its generelised not localised.
Coz u have CAL (2-3) all over that means its generelised but yes the staging will be decided from 8 mm CAL (even on one tooth)
Loved the way you taught the cases !!!!
Thank you !!!
Keep on blessing us !!!
You help people! Thank you for your bright lessons. Good bless you!
incredible summarization
This was very very helpful, thank you so much for making the effort to educate and share. There is just so many factors and I'm really struggling to pull it all together so I will be able to stage and grade without taking up half the appointment!
You’re very welcome! I’m so glad it was helpful for you 😊
Thank you so much Dr.Rayan
You make our studying easier
Much appreciated
Thank you sr. For your knowledge. You are the best.
you are absolutely the best. Thank you for the amazing, simple but yet highly educational videos.
You're very welcome!
I just love these videos! THANK YOU FROM THE BOTTON OF MY HEART
Thanks Again Ryan for making the concept easy and thanks for adding cases so that we can practice and get perfect.please make videos for dental anatomy.
It was great thanx for your generosity of your knowledge dr Rayan👌👌👌
Thank you!!! 📚 your videos help so much !
Nicely done .Please make some videos on clinical cases NBDE part 2 which comes in board exams .
How to interprete the clinical cases and their diagnosis most importantly the radiograph .
Thanks
Please upload few more case discussions like this. :) you are very Good teacher
easy, you are the master. Thanks a lot
Favorite doctor&Favorite channel ❤️ !
Thank you so much! 🙏🏼
Thank you Dr Ryan..very useful video you helped me so much .❤from kerala
You are wonderful,God bless you
Amazing and simple!
God bless you!
That’s great! God bless you as well 🙏🏼
Hey Ryan! I can't thank you enough for your videos and massive contribution to the dental community.
I do have a question regarding Case #4, I noticed that vertical bone loss was also present on tooth #13. However, you classified this as a Molar-Incisor pattern. I personally thought that it would be a Localized case given the affected premolar in this case. What do you think?
Good question! I arrived at the molar-incisor diagnosis because the vast, vast majority of the disease process is localized around the molars and incisors. Yes, there is some bone loss around #13 that is definitely noteworthy, but the pattern is clearly affecting the incisors and molars more than everything else.
Thank you so much. Great video.
Incredible review!! thank you!!
Good informations for best diagnosis.. Thank you Doctor...
Thank you Ryan for your videos!
Thank you Dr Ryan you are awesome
Thanks for a great video, now I understand the new perio classification clearly for the first time. Thank you!
awesome INBDE classification !!!!!
Thank you! 😁
Thank you for your awesome lecture 😊❤️
It is very good explaining
Great video. Please make a video on radiographic lesions and oral lesions malignant and benign..😊
thanks a lot dear doctor 🙏🙏🙏👍👍👍
Thanks Dr. Ryan!!!
I was able to answer the questions myself by Case#4 haha! Took some time, but I'm glad I learned something. Thank you Dr. Ryan. Much appreciated!
Glad it was helpful!
Thank you so much Sir.
Excellent.Thank you
Hi Dr. Ryan! Thank you so much for your helpful videos.🙏 Just wondering for Case #2 why do we count the 8mm CAL on the distal of tooth #3 as an interdental CAL when there’s no neighbouring tooth? In other words does interdental CAL not have to be between 2teeth?
thanks a lot. LOVE U SO MUCH
Thanks Doc love your videos
Hello
First of all thank you for your great effort
I have a question regarding the furcation involvement
You have said that furcation involvement Type 2 represents stage 3
While furcation involvement type 3 which is through and through represents stage 4
But if you look at the staging table in stage 3 both furcations type 2 and type 3 are there
If you can clarify this point I’ll be very thankful
Sorry if my English wasn’t that good
Thank you so much Dr.Ryan,i would also like to ask the following questions:
-how would the therapy plan designed according to the stages?For example, stage 3 grade B or C ?( previously,the therapy would be designed according to the chronic or the aggressive periodontitis)
-in the „radiological Interpretation” video,i hoped that you would incorporate the new classification,and so here, i would like to ask ,how would you suggest differential Diagnoses according to the new classification? For instance, could we describe (stage 3 Grade C , and Stage 4 Garde B) as separate differential diagnoses?
-as an example, A.A. Bacteria was directly related(but not deciding ) to aggressive periodontitis, how is it co-related to periodontitis according to the new classification?
Your efforts are much appreciated
The higher the stage and grade, the more strict maintenance that patient requires and the more likely they will need surgical treatment. Periodontists will typically give antibiotics for more “aggressive” cases (by that I mean Grade C), but they do this after scaling and root planing is completed for all four quadrants. Regardless of stage and grade though, plaque control is the most important component of periodontal therapy.
Thank you so much for the amazing explaining ... could u please upload avideo about bifurcation classification and treatment ????!!
The original Classification video in this series covers that topic!
This is a great lecture to create hygiene template
Thank you very much
i love this so much please do videos about dental physiology
Hello Doctor. Thank you so much for this video.
I have a question regarding case number two concerning the localized diagnosis. I understand that you diagnosed it as localized because the most severe CAL affected only a small number of teeth. But what about the remaining teeth ? All other teeth have CAL as well right?
Same comment here
hi i liked the cases for identification of staging and grading, can you pl share some more like them, they are really helpful. thanks in advance
asides from watching all of dr ryans videos and solving sample papers, what else should i use to study? and how much prep is covered by just dr ryans vids?
I definitely think my videos are the highest yield resource you can use to study. I also recommend using the Boards Mastery App for practice questions and getting the Mosby’s book that I link to in my video descriptions for studying and additional practice questions. Check out my Patreon page for more details. Best of luck to you!
Amazing explanation!! Thank you so much!!
Glad it was helpful!
I think Case # 2 is Grade B. The patient is already Stage III, which means there was already more than 30% bone loss. CAL of 8mm is already approx. half of the average root length. Assuming 50% bone loss, 50/70=0.7. Then after applying the grade modifiers (diabetes and smoking), there should be No change in grade.
hi sir , hope u r good , ur lectures are awesome
what to do and difference between all dental exams like ore and others and which one are for which purpose and which one is best
Hello Dr Ryan. I hope you are doing great. You have made a very concise and precise video for us. Thanks alot. Secondly is this new classification included in NBDE Part 2 Exam? Thank you.
Very nyc explanation. Thank u. Do u hv some more of practice questions with perio charts.
Hey Ryan! Could you please explain how progressive bone loss is evaluated for peri-implantitis, and how it differentiates from increased PD compared to baseline?
Thank you so much for the excellent video. I had a question. For Case #4 I see the premolars on the left side have significant bone loss yet it's described as Molar Incissor Pattern. Could someone please explain this?
Hey Dr Ryan! Do you know if we need to know this new classification system for NBDE part 2?
Yes, it is covered on that exam since summer of 2020!
thank you soo much!
Glad it helped!
YES!
Thank you Dr. Rayan
In case 2 the patient has 6 teeth that are missing, doesn't make her stage 4 ?
Thank you for your help
Thank you very much for this video. What is your opinion on use of Hydrogen peroxide for treatment of gum disease?
Thank you for your time.
thanks a lott
Hey Ryan...Can you explain case 3. Why we considered grade B?
Hi dr Ryan, thanks for incredible videos.
How can I find explanation for the chart in case 2 . Unfortunately I’m not that much familiar to the numbers and their locations in the dental arch.
You rock. You explained this wonderful. Question about grading - How can we grade if we have no info for the last 5 years? (For example: new patient, and/or patient that has no access to their dental charts)?
Bone loss (seen on radiograph) divided by age gives you primary criteria (between 1.0), also look for grade modifiers like smoking/diabetes etc.
@pegahqasemi8363 exactly ! The indirect evidence of progression . The % bone loss / age is a comprision between nominal and actual bone lost in percentage . Heavy biofilm deposits with low leveles of destruction means the host has healthy immune system and the progression is low . Now I need to learn this in German.
we were taught at dental school that the list is inclusive not exclusive. ie. that if a patient smokes more than 10 cigarettes a day they are automatically a grade C, no matter how stable they are which makes the classification system flawed.
Unfortunately, for lack of a better way of saying it, you were taught incorrectly. Here's a direct quote from the AAP:
"Only one grade is assigned to the patient. It is based on either direct or indirect evidence of the rate of disease progression and risk for future progression. Other risk factors or grade modifiers such as smoking and diabetes mellitus may also be considered for their contribution to the rate of disease progression in the present or the future.
For example, a patient with a Grade B rate of progression does NOT have to automatically become a C if his/her HbA1c is 7.2%, if in the judgment of the clinician the progression of the disease is not significantly impacted by this level of diabetes control. However, if the HbA1c is 9%, the impact on future attachment loss and response to therapy may be greater, which would prompt the clinician to assign a grade of C.
The same reasoning may be applied to a patient who smokes more than 10 cigarettes per day. The question to be asked is, 'What impact has the patient’s smoking habit had on the current amount of attachment loss and on future loss of attachment or response to therapy?'"
In other words, just because someone smokes 11 cigarettes a day doesn't automatically give them Grade C. As you said that makes no sense! If there is
@@mentaldental I am enlightened 🤤💭
Awesome video! One question however,
for the "Peri-Implant Disease and Conditions" section of the new classification, how important is the "Peri-Implant Soft and Hard Tissue Deficiencies" subsection?
That section is relatively unimportant for the board exam. If you're curious, that category under "Peri-Implant Diseases and Conditions" refers to defects in soft and hard tissues that are present PRIOR to implant placement which may be linked to a poor outcome of the implant.
Hey Dr Ryan
I have a doubt
If the CAL is 1-2mm
And PPD is 2 to 6 mm in the mouth
What stage will it be? Is CAL more important?
Hi Doctor , thank you so much for your help
I have a question , for chronic periodontitis is now considered as grade A,B and stage 1 and 2 ?!
I don't think that the new classification differentiates between acute and chronic periodontitis
why is case 4 Molar Incisor as it appears the premolars are affected on the LHS bitewing? But good to know that its not all the molar and incisor teeth affected that would classify it as molar incisor periodontitis
Thank u 🤍🤍🤍🤍🤍
Thank you so much Dr. Ryan! do we need to go with the new classifications for NBDE 2 or is this only for the INBDE exam?
You're welcome! And it is being integrated into both exams, although more so for the INBDE.
Dr. Ryan, case #3 seems like has grade C rather than B. On UR molar bone loss >60%, am I right?
Why is the interdental CAL more critical and the one that is used for grading severity? Why is a non-interdental deep pocket of 10mm not as significant?
Why case II is localised ? Aren’t all of the examined teeth have CAL , Or we consider only the ones that go along with staging , like if we’re on stage III we only include teeth that have >=5 mm ID CAL ? Like that?
Dr. please talk about dental cement😭😭
you will find topic of cements in prosthodontic series by dr Ryan
Great video but I disagree with u on case 3 it shows a generalized pattern and an RBL >50% around upper incisors so it should be generalized stage 3 grade c
Thanku
in which case is possible that the CAL is not available, and consequently we will need Rx? please I wanna know!
Please dr make a series for anatomy and bacteriology
is the furcation II/ III referring to the Hamp classification or the Glickman's? thank you !!
I am going to write my NBDE equivalency exam AFK in canada. Is the syllabus covered still relevant?
Yes! 💯