PROSTHODONTICS - American College of Prosthodontists

TOPICS OF INTEREST Classification System for Partial EdentulismThomas j. McGarry) DDS/ Arthur Nimmo, DDS/James F. Skiba) DDS/Robert H Ahlstrom) DDS) MS) 4 Christopher R. Smith) DDS) 5Jack H Koumjian) DDS) MSD)6 and Nancy S. Arbree, DDS) MS7The American College of Prosthodontists (ACP) has developed a classification system for partialedentulism based on diagnostic findings. This classification system is similar to the classificationsystem for complete edentulism previously developed by the ACP. These guidelines are intended tohelp practitioners determine appropriate treatments for their patients. Four categories of partialedentulism are defined, Class I to Class IV, with Class I representing an uncomplicated clinicalsituation and class IV representing a complex clinical situation. Each class is differentiated byspecific diagnostic criteria. This system is designed for use by dental professionals involved in thediagnosis and treatment of partially edentulous patients. Potential benefits of the system include (1)improved intraoperator consistency, (2) improved professional communication, (3) insurance reimbursementcommensurate with complexity of care, (4) improved screening tool for dental schooladmission clinics, (5) standardized criteria for outcomes assessment and research, (6) enhanceddiagnostic consistency, and (7) simplified aid in the decision to refer a patient.] Prosthodont 2002;11:181·193. Copyright © 2002 by The American College of Prosthodontists.INDEX WORDS: diagnosis, treatment planning, prosthodontics, dental education, outcomesassessment, quality assurance, treatment outcomes, patient risk profilesPARTIALLY EDENTULOUS patients exhibit a widerange of phys ical va riations and h ealth conditions. The a bse nce of organized diagnosticcriteri a for partia l ede ntulism has been a longstandi ng impedime nt to effective recogni tionJPrivate Practice, Oklahoma Cil)', OK.2Profe·Hor and Chainnan, Department o/Prosthodontics, Univmil)' 'IIFlorida College'll Dtnh'''J', Cainsville, FL.>Private Practice, Ill/onldalr, JIIJ.1Private Practice, Reno, NV, aild Associate Clini"al Professor, Department'II Restorative Denlifto" Univmity 'II the Pacific, Stockton, CA.5Associate Projessar, Department'll Clinical Su~ger)' , Universi t)' 'IIChica.~o, Chicago, IL."Clinical Associate Professor, Deparlment 'II Restorative Dentisto"Universil)' 'if California-San Francisco School 'II Dentist')', SanFrancsico, CA, and Private Practice, Palo A lto, CA.?Pr,!/imor and As.wciate Dean 'llAcademic AIJairs, Tufts UnivmirySchool'll Den tal Medicine and Private Practice, Boston, j\1A .Accepled April 8, 2002.Thil" project wasfu II ded b)! the A me1ican Colle,~e '!/ ProstilOdonlisls.Presented at Ihe Annual Sessions'll Ihe American Dental EducationAssociation, Washin,glon, DC, April 2, 2000, and the Ameri"a" Coliegl! 'IIProsthodol1tists, Hawaii, November 15, 2000.Cormpondence to: Thomas]. McCarl)', DDS, 4320 McAulq Blvd.,Oklahoma Cil)', OK 73120.Copyright © 2002 by The American Coliege ofProsthodontists1059-941X/02/1103-0006535 00/0doi. 10 1053/Jpro.2002. 126094of risk factors tha t may a ffect treatm e nt ou t­comes . Although described thoroughly in thedental li te rature,l.o the dive rse nat ure of pa r­tia l ede ntulism has no t been organize d in sucha way to g uid e de nta l profession als in the treatment planning process . T o address this problem,the American Coll ege of Prosthodontists(AC P) Subcommittee on Pros thodont ic Class i­ficat ion was form ed a nd ch arged with developinga class ific ation sys te m for partial ed entulismconsistent with the exis ting class ific a tionsys tem for complete edentulism. 2 A summaryof the ACP edentul ous class ification sys te m 1Sgive n in T abl e I.T he purpose of this class ification system is toprovid e a framework for the organization of clinicalobservations. Clinical variables that establish different leve ls of partial edentulism are organized ina simplified, sequential progression designed to facilitateconsis te nt and predictabl e treatment planningdecisions. T his framework is designed to indicateincre asing levels of diagnostic and treatmentcompl exity presented by patients with varying degreesof partial ede ntuJism. This may suggestpoints at which referral to other specialists is appropriate.The framework is structured to supportJ ournal of Prosthodonlics, Vol I I, No 3 (Sep lember), 2002: jJfJ 181-193 1812010 CDEL Re-recognition of the Specialty Report 160 of 279