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Grade C molar-incisor pattern periodontitis classification and its challenges.

Yasmin Teixeira das Graças¹, Manuela Maria Viana Miguel¹, Renato Corrêa Viana Casarin²

¹Center for Oral Health Research and Division of Periodontology, Department of Oral Health Practice, College of Dentistry, University of Kentucky, Lexington, Kentucky, USA.

Journal of Periodontology

|April 13, 2026

Summary

The current periodontitis classification has limitations, particularly excluding primary teeth and broadly categorizing severe cases. Refinements are needed to improve diagnosis and treatment for all patients, especially children.

Keywords:

incisor molar patients periodontitis

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Area of Science:

Dentistry
Periodontology
Public Health

Background:

The recent periodontitis classification offers improved severity and risk assessment.
However, limitations exist, especially concerning the grade C and molar-incisor pattern (C-MIP) classification.

Purpose of the Study:

This review identifies gaps in the C-MIP classification.
It highlights the need for improved categorization of periodontitis, particularly in specific patient groups.

Main Methods:

Literature review and critical analysis of the current periodontitis classification system.
Identification of limitations and areas for improvement.

Main Results:

The C-MIP classification excludes primary dentition, hindering early diagnosis and treatment.
Grade C periodontitis encompasses diverse patient profiles, masking key differences.
Atypical presentations and cases beyond the molar-incisor pattern pose classification challenges.

Conclusions:

Recommendations include recognizing periodontitis in primary dentition.
Distinguishing grade C periodontitis based on modifying factors is suggested.
A subclassification for young patients with grade C periodontitis is proposed to enhance diagnostic accuracy and targeted research.