Table 1.

Criteria for gross quadrant grade (GQG).

GQG	Degree	Gross lesion description
0	Absence	None
1	Slight	Discrete lesion, area of M2M3 or M1M2; minimal gingival recession; visible impacted materials (hair, food debris); inflammation at margin of impacted materials
2	Mild	Single large lesion area of M2M3 or M1M2 with ulceration/recession of lingual gingiva along 1/2 to 2/3 the mesiodistal aspect of the lingual gingival margin of one involved molar; limited extension into the lingual mucosa; OR presence of two separate GQG = 1 lesions within the same hemimaxilla/hemimandible; inflammation/swelling/redness at margin of impacted material
3	Moderate	Continuous recession/ulceration of gingiva involving entire mesiodistal aspect of lingual gingival margin of both involved molars; ulceration extending into lingual mucosa toward midline in maxilla or onto lingual mucosa (lingual plate) in mandible; inflammation/swelling/redness at margin of impacted material; possible involvement of buccal mucosa
4	Severe	Continuous gingival recession/ulceration involving all three molars; ulceration extending into lingual mucosa toward the midline and onto the buccal mucosa; gingival inflammation/swelling/redness at margin of impacted material; possible tooth migration or loss
MRONJ lesion		Lesion of GQG = 3 or 4 with exposure of alveolar or palatal bone

See Fig. 2A for corresponding photographs.