Decision making for optimal treatment for patients with periodontitis based on recent classification criteria

Objective: The study aimed to evaluate the accuracy and agreement of clinicians with different education levels and clinical experience in periodontitis diagnosis and treatment planning. Materials and Methods: Depending on the stage, grade, and extent components of periodontitis, a consensus diagnosis and treatment plan document prepared by two experienced periodontists was used as a gold-standard. An anonymous survey including 10 periodontitis cases was given to 15 participants (5 periodontal experts (PE), 5 postgraduate periodontology students (PS), and 5 undergraduate dental students (DS)) and asked them to classify each case depending on the components of the disease and select their treatment plan from a multiple-choice questionnaire including 11 dental treatment options. The accuracy of the responses was detected by referring to the gold-standard and inter-examiner agreement levels were also assessed. Results: Except grade, no significant inter-group difference was found in the periodontitis components and this difference only existed in the PE group (p=0.012). PE group gave more accurate treatment planning responses compared to others. The agreement levels of all examiners for stage, grade, and extent were fair (κ=0.366, 0.222, and 0.287, respectively). Treatment planning showed low agreement (κ<0.31) except tooth extraction option (κ=0.554). Both diagnosis and treatment planning responses showed significant variations amongst groups. Conclusion: Although education level and experience showed superiority in terms of periodontitis diagnosis and treatment planning, the results with low accuracy indicate the need for calibration to reduce the variations and enhance the accuracy.