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The 2018 Classification of Periodontitis: Challenges from Clinical Perspective.

Marek Chmielewski1, Andrea Pilloni2, Alessandro Cuozzo3

  • 1Private Practice, 81-881 Sopot, Poland.

Dentistry Journal
|August 27, 2025
PubMed
Summary

The 2018 AAP/EFP Periodontitis Classification presents clinical challenges, impacting diagnostic accuracy and consistency. Enhanced training and AI tools can improve periodontitis diagnosis and patient care.

Keywords:
classificationdata accuracydiagnosisperiodontal diseaseperiodontitisreproducibility of results

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Area of Science:

  • Dentistry
  • Periodontology
  • Clinical Diagnostics

Background:

  • The 2018 AAP/EFP Classification of Periodontitis aims to standardize diagnosis.
  • Clinical application of this classification has revealed challenges in diagnostic accuracy and examiner consistency.

Purpose of the Study:

  • To evaluate clinical challenges in applying the 2018 AAP/EFP Periodontitis Classification.
  • To assess diagnostic accuracy and inter/intra-examiner agreement with and without implementation tools.

Main Methods:

  • Narrative review of eleven studies.
  • Inclusion of studies reporting diagnostic accuracy and examiner agreement for the 2018 Classification.
  • Analysis of data from 459 clinical cases and 852 examiners.

Main Results:

  • General dentists showed lower accuracy and consistency than specialists.
  • Challenges identified in staging periodontitis and grading reliability.
  • Training and implementation tools significantly improved diagnostic accuracy and agreement.

Conclusions:

  • Variability exists in applying the 2018 Classification.
  • Enhanced clinician training, diagnostic aids, and AI can improve accuracy.
  • Improved diagnosis is crucial for prevalence estimation, research, and treatment planning.