PROSTHODONTICS - American College of Prosthodontists

September 2002, Volume I I, Number 3183diagnostically driven treatment plan options andwill also be useful in an educational environmentfor triaging the patient upon entry into an institutionalsetting.Partial edentulism is defined as the absenceof some bu t not all of the natu ral tee th in adental arch. In a partially edentulous patient,the loss and continuing degradation of the alveolarbone, adjacent teeth, and supportingstructures influence the leve l of difficulty inachieving adequate prosthetic restoration.The quality of the supporting structures contributesto the overall condition and is considered in the diagnostic levels of the classificationsystem.Only the most significant diagnostic criteriahave been id entified. Selection ofappropriate treatment will be developed subsequently in a Parametersof Care document 3 It is anticipated that boththe edentulous and partially edentulous classificationsys tems will be incorporated into existing electronicdiagnostic and procedural databases (SNO­DENT, lCD, CPT, and CDT).The classification system is intended to offer thefollowing benefits:1. Improved intraoperator consis tency2. Improved professional communication3. Insurance reimbursement commensurate withcomplexity of care4. An objective method for patient screening indental education5. Standardized criteria far outcomes assessmentand research6. Improved diagnostic consistency7. A simplified, organized aid in the decision-makingprocess relating to referral.ApplicationsDiagnos is must be determined before treatment recommendations can be made. Whilethis classification sys tem is not a predictor ofsuccess of the pros thodon ti c trea tmen t, clinicalou tcomes will be evaluated in terms of evidence-based criteria.When combined with the Parameters of Caredocument, this cl ass ification sys tem will provide abasis for diagnos is and treatment procedures. Theexperiences gained \"ill enable updating of the Parametersof Care. The classification system will besu bject to revision based upon inpu t from clinicians,as well as when new diagnostic and treatment informationbecomes available.Review of the Diagnostic CriteriaThis section describes four broad diagnostic categoriesrelevant to classification of partially edentulouspatients:1. Location and exten t of the edentulous area(s)2. Condition of abutments3. O cclusion4. Residual ridge characteristics.The criteria descriptions begin with the leas tcomplicated and progress to the most complicated.The diagnostic criteria are as follows.Criteria 1.- Location and Extent of theEdentulous Area(s)A. Ideal or minimally compromised edentulous areaThe edentulous span is confined to a single archand I of the following:• Any anterior maxillary edentulous area that doesnot exceed 2 incisors• Any anterior mandibular edentulous area thatdoes not exceed 4 incisors• Any posterior maxillary or mandibular edentulousarea that does not exceed 2 premolars, or Ipremolar and 1 molar.B. Moderately compromised edentulous areaEdentulous areas in both arches and in I of thefollowing:• Any anterior maxillary edentulous area that doesnot exceed 2 incisors• Any anterior mandibular edentulous area thatdoes not exceed 4 incisors• Any posterior maxillary or mandibular edentulousarea that does not exceed 2 premolars, or 1premolar and I molar• A missing m axill ary or mandibular canin e.C. Substantially compromised edentulous area• Any posterior m axillary or mandibular edentulousarea greate r than 3 teeth or 2 molars• Any edentulous areas including anterior and posteriorareas of 3 or more teeth.2010 CDEL Re-recognition of the Specialty Report 162 of 279