PROSTHODONTICS - American College of Prosthodontists

TOPICS OF INTERESTClassification System forComplete EdentulismThomas J. McGamy, DDS51hthurNimmo, DDS: James F. Skiba, DDS?Robert H. Ahlstrom, DDS, Christopher R. Smith, DDS,'and Jack H. Koumjian, DDS, MSD'The American College of Prosthodontists has developed a classification system for completeedentulism based on diagnostic findings. These guidelines may help practitioners determineappropriate treatments for their patients. Four categories are defined, ranging from Class I to ClassIV, with Class I representing an uncomplicated clinical situation and a Class IV patient representingthe most complex and higher-risk situation. Each class is differentiated by specific diagnosticcriteria. This system is designed for use by dental professionals who are involved in the diagnosis ofpatients requiring treatment for complete edentulism. Potential benefits of the system include: 1)better patient care, 2) improved professional communication, 3) more appropriate insurancereimbursement, 4) a better screening tool to assist dental school admission clinics, and 5)standardized criteria for outcomes assessment.J Prosthod 1999;8:27-39. Copyright 0 7999 by The American College of Prosthodontists.INDEX WORDS: complete dentures, diagnosis, treatment planning, prosthodontics, dentaleducation, graduate dental education, outcomes assessment, quality assurance, treatment outcomesOMPLETELY EDE,WLOUS PATIEhTS ex-C hibit a broad range of physical variations andhealth concerns. Classifying all edentulous patientsas a single diagnostic group is insensitive to themultiple levels of physical variation and the differingtreatment procedures required to restore functionand comfort. A graduated classification of completeedentulism has been developed that descri bPsvarying levels of loss of denture-supporting structures.This article defines complete edentulism as follows:the physical state of the jaw(s) following removal'Private pactice, Oklahoma Ciy, OK.2Projsjor and firedor ofrmplant Dentistly, Department oJRaloratilieDentistv, UniL'ewip ofDetrait Mery School of Lkntistv, Iletmit, ~2.11j'Pnvate practim, hfontontclair, iVJ4Priaatepractice, Reno, AT?-"-Pnvatepl-actice, San Antonio, TX.6Clinical Projtsw, Department $Restorative DentijQ, UCSF SchoolojDentisty andPricate Practice, Palo Alto, CA.ilzwptedJanuay 21,1999.Presented at the Annual Session ofthe Adcan Coliege of Prosthodoiitistsin Orlando, FL, Navember5,1997.Fun& lg The h i a n Colleze oJPmsthhodontis~.CnrresfnmdPnce to: Thomas J. McGaq DDS, 4320 McAulq Boubvard,Oklahoma Cab, OK 73120.Co&yright 0 1999 b The American Coliege ojPmsthodontists10.59-94 lX~~9i~80~-~OO5$5.00/0of all erupted teeth and the condition ofthe supportingstructures available for reconstructive or replacementtherapies. The condition of edentulism, for thepurpose of this article, is divided into four levelsaccording to specific diagnostic criteria.The absence of organized diagnostic criteria forcomplete edentulism has been a long-standing impedimentto effective care for patients. Recognitionof the diverse nature, scope, and degree of completeedentulism, although thoroughly described in thedental literature, has not been organized to efficientlyguide dental educators, general dentists,prosthodontists, and third-party payers in providingthe appropriate treatment for each patient. A systemfor facilitating patient identification is needed toimprove patient treatment outcomes.The American College of Prosthodontists (ACP)recognized its responsibility to the public and theprofession to correct this dilemma. The Subcommitteeon Prosthodontic Classification was formedin 1995 and charged with developing classificationsystems for prosthodontic patients. Timelyimplementation of this system will benefit patients,clinicians, and educators. The classification systemfor complete edentulism is presented in the followingsections.Journal ofProsthodontics, Vol8, No 1 (Marcti)> 1999:H 27-39 272010 CDEL Re-recognition of the Specialty Report 146 of 279