{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T16:51:26Z","timestamp":1787676686800,"version":"build-2784847793"},"reference-count":28,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2020,12,14]],"date-time":"2020-12-14T00:00:00Z","timestamp":1607904000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Clinic Periodontology"],"published-print":{"date-parts":[[2021,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>The objective of this study was to evaluate consistency and accuracy of the periodontitis staging and grading classification system.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Thirty participants (10 periodontal experts, 10 general dentists and 10 undergraduate students) and a gold\u2010standard examiner were asked to classify 25 fully documented periodontitis cases twice. Fleiss kappa was used to estimate consistency across examiners. Intraclass correlation coefficient (ICC) was used to calculate consistency across time. Quadratic weighted kappa and percentage of complete agreement versus gold standard were computed to assess accuracy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Fleiss kappa for stage, extent and grade were 0.48, 0.37 and 0.45 respectively. The highest ICC was provided by students for stage (0.91), whereas the lowest ICC by general dentists for extent (0.79). Pairwise comparisons against gold standard showed mean value of kappa &gt;0.81 for stage and &gt;0.41 for grade and extent. Agreement with the gold standard for all three components of the case definition was achieved in 47.2% of cases. The study identified specific factors associated with lower consistency and accuracy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Diagnosis was highly consistent across time and moderately between examiners. Accuracy was almost perfect for stage and moderate for grade and extent. Additional efforts are required to improve training of general dentists.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jcpe.13406","type":"journal-article","created":{"date-parts":[[2020,12,1]],"date-time":"2020-12-01T20:23:35Z","timestamp":1606854215000},"page":"205-215","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":58,"title":["The staging and grading system in defining periodontitis cases: consistency and accuracy amongst periodontal experts, general dentists and undergraduate students"],"prefix":"10.1111","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6662-2644","authenticated-orcid":false,"given":"Lorenzo","family":"Marini","sequence":"first","affiliation":[{"name":"Section of Periodontics Department of Oral and Maxillofacial Sciences Sapienza University of Rome Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2743-0137","authenticated-orcid":false,"given":"Maurizio S.","family":"Tonetti","sequence":"additional","affiliation":[{"name":"Division of Periodontology and Implant Dentistry Faculty of Dentistry the University of Hong Kong Hong Kong China"},{"name":"Department of Oral and Maxillo\u2010facial Implantology Shanghai Key Laboratory of Stomatology National Clinical Research Centre for Stomatology Shanghai Ninth People Hospital School of Medicine Shanghai Jiao Tong University Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7750-5010","authenticated-orcid":false,"given":"Luigi","family":"Nibali","sequence":"additional","affiliation":[{"name":"Periodontology Unit Centre for Host\u2010Microbiome Interactions Faculty of Dental and Craniofacial Sciences King\u2019s College London London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8712-0958","authenticated-orcid":false,"given":"Mariana A.","family":"Rojas","sequence":"additional","affiliation":[{"name":"Section of Periodontics Department of Oral and Maxillofacial Sciences Sapienza University of Rome Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0657-0787","authenticated-orcid":false,"given":"Mario","family":"Aimetti","sequence":"additional","affiliation":[{"name":"Department of Surgical Sciences, C.I.R. Dental School Section of Periodontology University of Turin Turin Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3781-1715","authenticated-orcid":false,"given":"Francesco","family":"Cairo","sequence":"additional","affiliation":[{"name":"Research Unit in Periodontology and Periodontal Medicine Department of Experimental and Clinical Medicine University of Florence Florence Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raffaele","family":"Cavalcanti","sequence":"additional","affiliation":[{"name":"Section of Periodontology Department of General Surgery and Medical\u2010Surgical Specialties School of Dentistry University of Catania Catania Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Crea","sequence":"additional","affiliation":[{"name":"Private Practice Viterbo Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Ferrarotti","sequence":"additional","affiliation":[{"name":"Department of Surgical Sciences, C.I.R. Dental School Section of Periodontology University of Turin Turin Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8780-7306","authenticated-orcid":false,"given":"Filippo","family":"Graziani","sequence":"additional","affiliation":[{"name":"Sub\u2010Unit of Periodontology, Halitosis and Periodontal Medicine Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine University of Pisa Pisa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luca","family":"Landi","sequence":"additional","affiliation":[{"name":"Private Practice Rome and Verona Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicola M.","family":"Sforza","sequence":"additional","affiliation":[{"name":"Private Practice Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3610-6574","authenticated-orcid":false,"given":"Cristiano","family":"Tomasi","sequence":"additional","affiliation":[{"name":"Department of Periodontology Institute of Odontology The Sahlgrenska Academy at University of Gothenburg Gothenburg Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6268-1863","authenticated-orcid":false,"given":"Andrea","family":"Pilloni","sequence":"additional","affiliation":[{"name":"Section of Periodontics Department of Oral and Maxillofacial Sciences Sapienza University of Rome Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,12,14]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/jcpe.12947"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1902\/annals.1999.4.1.1"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1186\/cc2955"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1902\/jop.2010.100278"},{"issue":"20","key":"e_1_2_11_6_1","first-page":"S1","article-title":"A new classification scheme for periodontal and peri\u2010implant diseases and conditions \u2013 Introduction and key changes from the 1999 classification","volume":"45","author":"Caton J. G.","year":"2018","journal-title":"Journal of Clinical Periodontology"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.2334\/josnusd.51.199"},{"issue":"1","key":"e_1_2_11_8_1","doi-asserted-by":"crossref","DOI":"10.2202\/1557-4679.1275","article-title":"Sample size requirements for interval estimation of the kappa statistic for interobserver agreement studies with a binary outcome and multiple raters","volume":"6","author":"Donner A.","year":"2010","journal-title":"International Journal of Biostatatistics"},{"key":"e_1_2_11_9_1","first-page":"211","volume-title":"Statistical methods for rates and proportions","author":"Fleiss J. L.","year":"1981"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-051X.1975.tb01734.x"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0757.2011.00436.x"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/jcpe.12941"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/JPER.17-0556"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.H.01624"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM197509252931307"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/JPER.19-0557"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2010.03.002"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.2307\/2529310"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1902\/annals.1999.4.1.53"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.11613\/BM.2012.031"},{"key":"e_1_2_11_21_1","volume-title":"Textbook of Periodontia","author":"Miller S. C.","year":"1950"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1902\/jop.1972.43.1.38"},{"key":"e_1_2_11_23_1","first-page":"397","article-title":"The Smile Esthetic Index (SEI): A method to measure the esthetics of the smile. An intra\u2010rater and inter\u2010rater agreement study","volume":"8","author":"Rotundo R.","year":"2015","journal-title":"European Journal of Oral Implantology"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/jcpe.13290"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/jcpe.13286"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1093\/ptj\/85.3.257"},{"key":"e_1_2_11_27_1","doi-asserted-by":"crossref","DOI":"10.1093\/oso\/9780198528470.001.0001","volume-title":"Health measurement scales: a practical guide to their development and use","author":"Streiner D. L.","year":"2003"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.1111\/jcpe.12945"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.1111\/jcpe.13104"}],"container-title":["Journal of Clinical Periodontology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jcpe.13406","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jcpe.13406","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jcpe.13406","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,8,18]],"date-time":"2024-08-18T06:50:13Z","timestamp":1723963813000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jcpe.13406"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,12,14]]},"references-count":28,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2021,2]]}},"alternative-id":["10.1111\/jcpe.13406"],"URL":"https:\/\/doi.org\/10.1111\/jcpe.13406","archive":["Portico"],"relation":{},"ISSN":["0303-6979","1600-051X"],"issn-type":[{"value":"0303-6979","type":"print"},{"value":"1600-051X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,12,14]]},"assertion":[{"value":"2020-06-24","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-11-24","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-12-14","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}