The 2018 periodontitis case definition improves accuracy performance of full-mouth partial diagnostic protocols

We aimed to compare the accuracy performance of the new 2018 periodontitis case definition by the European Federation of Periodontology (EFP)/ American Association of Periodontology (AAP) with Centers for Disease Control (CDC)/AAP 2012 in full-mouth partial recording protocols (PRP). Retrospective data from NHANES 2011-2012 and 2013-2014 were analyzed. For each case definition, full-mouth diagnostic was defined as the reference standard. Patients were diagnosed for the presence of periodontitis and staging for each PRP. Sensitivity, specificity, accuracy and precision, through several indicators, were determined. Performance measurement was assessed through binary and multiclass ROC/AUC analyses. Our performance analysis shows that the new 2018 classification outperforms the 2012 classification regarding the diagnosis and staging of periodontitis on full-mouth PRPs. This recent case definition has strengthened the utility of PRPs and its improvements certainly explain the observed findings. Also, our findings contribute to the reliability of PRPs and its use in future worldwide epidemiological surveys.