Periodontal Osseous Defects: A Treatment-Oriented Classification to Guide Regenerative Treatment Planning

Periodontal bony defects are classified as supraosseous (suprabony) or infraosseous (infrabony) according to the location of the base of the defect compared to the coronal part of the residual alveolar crest. Infraosseous defects are generally considered more challenging to treat and are thought to be associated with a higher risk of periodontal progression. The emergence and advancement of regenerative periodontal procedures have improved clinicians' ability to manage infraosseous defects. However, limitations still exist. This paper reviews the definitions of periodontal osseous defects and provides a new classification framework for infraosseous defects, relating them to the chances of successful regenerative procedures and therefore to their treatment planning options. Infraosseous defects are hereby divided into intrabony and interroot defects. Factors affecting treatment response-such as the number of walls, depth, and extension into buccal and lingual surfaces- are added to the classification framework.