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Jepsen S et al. J Clin Periodontol 2018; 45 (Suppl 20): S219–S229

There are rare systemic conditions with a major effect on the course of periodontitis and more common conditions with variable effects, as well as conditions affecting the periodontal apparatus independently of dental plaque biofilm-induced inflammation. Diabetes and smoking should be recognised as important modifying factors and included in a clinical diagnosis of periodontitis as a descriptor. Gingival phenotype, is recognised and a classification for gingival recessions is introduced. Traumatic occlusal forces lead to adaptive mobility in teeth with normal support, but progressive mobility in teeth with reduced support. Biologic width is replaced by supracrestal tissue attachment – infringement is associated with inflammation and/or loss of periodontal supporting tissue.