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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
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.
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.
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