Skip to main content
. 2020 Mar 31;11:511. doi: 10.3389/fimmu.2020.00511

Figure 2.

Figure 2

IMPEDE, Periodontal Disease Classification Stages and Treatment.The IMPEDE model proposes that inflammation can manifest for each periodontitis classification stage as a principal driver of the clinical condition. In keeping within the framework of the current classification of periodontitis, the IMPEDE model identifies 5 stages (0–IV) integrating the transition from health, to gingivitis and (if untreated) ultimately to periodontitis. (A) IMPEDE stages within the new classification framework. 0 = Periodontal Health; Stage I = Gingivitis (initiation of inflammation); Stage II = Initiation/early periodontitis (Polymicrobial diversity emerges); Stage III = Advancing Periodontitis (dysregulated inflammation and pocket formation) and Stage IV = Late stage periodontitis (Inflammation mediated dysbiosis, opportunistic infection and advanced tissue destruction). (B) Inflammation-mediated polymicrobial dysbiosis and tissue damage can be exacerbated if no treatment is provided or can be driven toward resolution of inflammation and tissue repair/regeneration if treatment is provided.