Abstract：
Periodontal health is defined by absence of clinically detectable inflammation. There is a biological level of immune surveillance that is consistent with clinical gingival health and homeostasis. Clinical gingival health may be found in a periodontium that is intact, i.e. without clinical attachment loss or bone loss, and on a reduced periodontium in either a non-periodontitis patient (e.g. in patients with some form of gingival recession or following crown lengthening surgery) or in a patient with a history of periodontitis who is currently periodontally stable. Clinical gingival health can be restored following treatment of gingivitis and periodontitis. However, the treated and stable periodontitis patient with current gingival health remains at increased risk of recurrent periodontitis, and accordingly, must be closely monitored. Two broad categories of gingival diseases include non-dental plaque biofilm-induced gingival diseases and dental plaque-induced gingivitis. Non-dental plaque biofilm-induced gingival diseases include a variety of conditions that are not caused by plaque and usually do not resolve following plaque removal. Such lesions may be manifestations of a systemic condition or may be localized to the oral cavity. Dental plaque-induced gingivitis has a variety of clinical signs and symptoms, and both local predisposing factors and systemic modifying factors can affect its extent, severity, and progression. Dental plaque-induced gingivitis may arise on an intact periodontium or on a reduced periodontium in either a non-periodontitis patient or in a currently stable \"periodontitis patient\" i.e. successfully treated, in whom clinical inflammation has been eliminated (or substantially reduced). A periodontitis patient with gingival inflammation remains a periodontitis patient (Figure 1), and comprehensive risk assessment and management are imperative to ensure early prevention and/or treatment of recurrent/progressive periodontitis. Precision dental medicine defines a patient-centered approach to care, and therefore, creates differences in the way in which a \"case\" of gingival health or gingivitis is defined for clinical practice as opposed to epidemiologically in population prevalence surveys. Thus, case definitions of gingival health and gingivitis are presented for both purposes. While gingival health and gingivitis have many clinical features, case definitions are primarily predicated on presence or absence of bleeding on probing. Here we classify gingival health and gingival diseases/conditions, along with a summary table of diagnostic features for defining health and gingivitis in various clinical situations.
摘要：
牙周健康定义为不存在临床可检测的炎症。免疫监视的生物学水平与临床牙龈健康和体内平衡一致。临床牙龈健康可以在完整的牙周组织中发现，即没有临床附着丧失或骨丢失，以及非牙周炎患者（例如，患有某种形式的牙龈退缩或牙冠延长手术后的患者）或有牙周炎病史且目前牙周稳定的患者的牙周组织减少。在治疗牙龈炎和牙周炎后，可以恢复临床牙龈健康。然而,治疗和稳定的牙周炎患者与当前牙龈健康仍然在复发牙周炎的风险增加，因此，必须密切监测。牙龈疾病的两大类包括非牙菌斑生物膜诱导的牙龈疾病和牙菌斑诱导的牙龈炎。非牙菌斑生物膜诱导的牙龈疾病包括不是由牙菌斑引起的并且通常在牙菌斑去除后不解决的各种病症。这种病变可以是全身性病症的表现,或者可以局限于口腔。牙菌斑引起的牙龈炎有多种临床体征和症状,局部诱发因素和系统改变因素都会影响其程度，严重程度,和进步。在非牙周炎患者或目前稳定的“牙周炎患者”中，即成功治疗的牙菌斑诱发的牙龈炎可能出现在完整的牙周膜上或减少的牙周膜上，临床炎症已消除（或大大减少）。患有牙龈炎症的牙周炎患者仍然是牙周炎患者（图1），全面的风险评估和管理对于确保早期预防和/或治疗复发性/进行性牙周炎至关重要。精准牙科医学定义了以患者为中心的护理方法，因此,在临床实践中定义牙龈健康或牙龈炎的“病例”的方式与人口患病率调查中的流行病学方式不同。因此，同时提供了牙龈健康和牙龈炎的案例定义。虽然牙龈健康和牙龈炎有许多临床特征，病例定义主要基于探查时有无出血.在这里，我们对牙龈健康和牙龈疾病/状况进行分类，以及用于定义各种临床情况下的健康和牙龈炎的诊断特征汇总表。
