{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,4]],"date-time":"2026-10-04T15:18:39Z","timestamp":1791127119064,"version":"4.1.0"},"reference-count":67,"publisher":"Wiley","issue":"S29","license":[{"start":{"date-parts":[[2025,5,7]],"date-time":"2025-05-07T00:00:00Z","timestamp":1746576000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Clinic Periodontology"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To evaluate the performance and implementation of the 2018 Classification of Periodontal Diseases for periodontitis through systematic review and survey methodology.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>A two\u2010part systematic review was conducted. Part 1 aimed, with descriptive statistics, to evaluate performance metrics of the 2018 Classification, including diagnostic accuracy, prognostic performance and examiner reliability. Part 2 used thematic analysis to elucidate facilitators and barriers to the implementation of the classification. A survey collected evidence of barriers, facilitators and local implementation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Part 1 of this review included 14 individual studies of moderate risk of bias. Eight studies examined diagnostic accuracy, three studies examined prognostic efficacy and three studies examined inter\u2010\/intra\u2010rater reliability. Part 2 included 33 individual studies with data considered at high risk of bias. The survey returned 1113 responses. The thematic analysis in Part 2 led to seven findings, five related to facilitators and two concerning barriers to the implementation. Survey results showed that 78% of respondents currently use the classification, but the most common concerns relate to its complexity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The 2018 Classification performs well as a classification in comparison with previous classifications. Specific identified barriers have potentially limited the comprehensive uptake of the classification.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jcpe.14170","type":"journal-article","created":{"date-parts":[[2025,5,7]],"date-time":"2025-05-07T19:59:48Z","timestamp":1746647988000},"page":"34-57","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Evaluating the Performance and Implementation of the 2018 Classification of Periodontal Diseases: A Systematic Review and Survey"],"prefix":"10.1111","volume":"52","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9127-5530","authenticated-orcid":false,"given":"Nicola X.","family":"West","sequence":"first","affiliation":[{"name":"Clinical Trials Unit, Periodontology Bristol Dental School, University of Bristol  Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2628-9928","authenticated-orcid":false,"given":"Alexander","family":"Gormley","sequence":"additional","affiliation":[{"name":"Clinical Trials Unit, Periodontology Bristol Dental School, University of Bristol  Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7474-5732","authenticated-orcid":false,"given":"Alexander J.","family":"Pollard","sequence":"additional","affiliation":[{"name":"Clinical Trials Unit, Periodontology Bristol Dental School, University of Bristol  Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4902-7813","authenticated-orcid":false,"given":"Rossana","family":"Izzetti","sequence":"additional","affiliation":[{"name":"Universit\u00e0 di Pisa  Pisa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1088-2046","authenticated-orcid":false,"given":"Crystal","family":"Marruganti","sequence":"additional","affiliation":[{"name":"University College London  London United\u00a0Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8780-7306","authenticated-orcid":false,"given":"Filippo","family":"Graziani","sequence":"additional","affiliation":[{"name":"Universit\u00e0 di Pisa  Pisa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,5,7]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/idh.12627"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/jcpe.13618"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/cre2.526"},{"key":"e_1_2_9_5_1","volume-title":"Practical Statistics for Medical Research","author":"Altman D. 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