{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T15:53:44Z","timestamp":1782921224800,"version":"3.54.5"},"reference-count":33,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["aap.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Periodontology"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Despite the introduction of the 2017 periodontal disease classification system to enhance diagnostic accuracy, several concerns persist regarding its implementation in clinical situations. The prevalence of diagnostic errors in periodontics remains relatively high, with limited data available on the impact of different training levels and institutional approaches on the diagnostic accuracy and competency of students and practitioners. This study aims to explore the patterns of diagnostic accuracy and perceived confidence and familiarity with utilizing the 2017 periodontal classification system across various levels of clinical complexity, different educational levels, and two Canadian institutions<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This prospective cross\u2010sectional study included 104 participants from two universities, including third\u2010 and fourth\u2010year dental students, dental hygiene degree students, periodontics residents from five programs, and clinical instructors in periodontics and dental hygiene. Participants were asked to diagnose five de\u2010identified clinical cases along the spectrum of periodontal health and disease. Gold standard diagnoses were established by board\u2010certified periodontists. Diagnostic accuracy, error patterns, and factors influencing diagnostic decisions were analyzed using chi\u2010square tests,\n                      <jats:italic>t<\/jats:italic>\n                      \u2010tests, and a content analysis approach.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The overall diagnostic accuracy ranged from 18.3% to 53.8%. Clinical instructors achieved the highest accuracy (58.3%), followed by residents (52.9%), fourth\u2010year dental students (45.2%), dental hygiene degree students (36.5%), and third\u2010year dental students (26.4%). Statistically significant institutional differences were identified in Cases 1 (\n                      <jats:italic>\u03c7<\/jats:italic>\n                      <jats:sup>2\u00a0<\/jats:sup>\n                      = 7.62,\u00a0\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.01) and 4\u00a0(\n                      <jats:italic>\u03c7<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      = 4.04,\u00a0\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.05). Common errors included underdiagnosis (32.4%), incorrect periodontal status identification (28.7%), and wrong extent classification (21.3%). Qualitatively, participants frequently described the classification system as \u201cambiguous\u201d with substantial \u201cgray zones\u201d.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Regardless of the training level, diagnostic accuracy with the 2017 classification system remains suboptimal. Institutional variations suggest that curricular approaches may significantly impact the development of diagnostic skills and their diagnostic competency. These findings highlight the need for calibration protocols, targeted teaching and learning interventions, and technology\u2010supported learning tools to improve diagnostic skills in periodontal education.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jper.70164","type":"journal-article","created":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T15:38:33Z","timestamp":1782920313000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Evaluating diagnostic precision in applying the 2017 periodontal disease framework: A Canadian study across training levels"],"prefix":"10.1002","author":[{"given":"Nisha","family":"Patel","sequence":"first","affiliation":[{"name":"Department of Oral Biological and Medical Sciences, Faculty of Dentistry University of British Columbia  Vancouver Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5534-8790","authenticated-orcid":false,"given":"Tala","family":"Maragha","sequence":"additional","affiliation":[{"name":"Faculty of Dentistry University of Petra  Amman Jordan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7520-5252","authenticated-orcid":false,"given":"Jim Yuan","family":"Lai","sequence":"additional","affiliation":[{"name":"Faculty of Dentistry University of Toronto  Toronto Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rana","family":"Tarzemany","sequence":"additional","affiliation":[{"name":"Department of Oral Biological and Medical Sciences, Faculty of Dentistry University of British Columbia  Vancouver Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed","family":"Hieawy","sequence":"additional","affiliation":[{"name":"Department of Oral Biological and Medical Sciences, Faculty of Dentistry University of British Columbia  Vancouver Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9037-3107","authenticated-orcid":false,"given":"HsingChi","family":"von Bergmann","sequence":"additional","affiliation":[{"name":"Department of Oral Health Sciences, Faculty of Dentistry University of British Columbia  Vancouver Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,1]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1155\/2020\/2146160"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jdent.2020.103417"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.21815\/JDE.017.016"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.21815\/JDE.018.029"},{"key":"e_1_2_9_6_1","volume-title":"Improving Diagnosis in Health Care","author":"Committee on Diagnostic Error in Health Care","year":"2015"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600\u20100757.2011.00416.x"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12903\u2010022\u201002565\u20109"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.21815\/JDE.018.037"},{"key":"e_1_2_9_10_1","doi-asserted-by":"crossref","unstructured":"CatonJG ArmitageG BerglundhT et\u00a0al.A new classification scheme for periodontal and peri\u2010implant diseases and conditions\u2014Introduction and key changes from the 1999 classification.J Clin Periodontol. 2018;45(Suppl 20):S1\u2010S8. doi:10.1111\/jcpe.12935","DOI":"10.1002\/JPER.18-0157"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12903\u2010020\u201001371\u20105"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/jcpe.13104"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/jdd.13037"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/jicd.12411"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/jdd.12964"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/jdd.12636"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/jcpe.13406"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/jper.70011"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.54589\/aol.38\/2\/154"},{"key":"e_1_2_9_20_1","unstructured":"Government of British Columbia.Health professions act: dental hygienists regulation. 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