Diagnostic reproducibility of the 2018 Classification of Gingival Recession Defects and Gingival Phenotype: A multicenter inter‐ and intra‐examiner agreement study

Abstract

Background The aim of this study was to investigate the inter‐ and intra‐examiner agreement among international experts on the diagnosis of gingival recession defects using the 2018 Classification of Gingival Recession Defects and Gingival Phenotype as proposed in the 2017 World Workshop. Methods Standardized intraoral photographs from 28 gingival recession defects were evaluated twice by 16 expert periodontists. Recession type (RT), recession depth (RD), keratinized tissue width (KTW), gingival thickness (GT), detectability of the cemento‐enamel junction (CEJ), and presence of root steps (RS) were recorded and used for the analysis. Intra‐ and inter‐examiner agreements were calculated for individual variables and for the overall classification. Intraclass correlation coefficient with 95% CI was used for RD and KTW; Kappa with 95% CI was used for GT, CEJ, and RS; quadratic weighted Kappa with 95% CI was used for RT. Results Overall intra‐ and inter‐examiner agreements were highest for KTW (0.95 and 0.90), lowest for GT (0.75 and 0.41), with the other variables in between (RD: 0.93 and 0.68, RS: 0.87 and 0.65, RT: 0.79 and 0.64, CEJ: 0.75 and 0.57). Overall intra‐ and inter‐examiner agreements for the matrix were 62% and 28%, respectively. Significant effects existed between one variable's measurement and other variables’ agreements. Conclusions The 2018 Classification of Gingival Recession Defects and Gingival Phenotype is clinically reproducible within the examiners, and when the variables forming the matrix are analyzed individually. The between‐examiner agreement for the complete matrix showed lower reproducibility. The agreement was highest for KTW and RD, and least for GT.

Challenges and success in periodontal plastic surgery

“…During the 2017 World Workshop, relevant information was summarized in a new official classification of gingival recessions, which was proposed and jointly approved by the American Academy of Periodontology and the European Federation of Periodontology. This new classification, named the 2018 Classification of Gingival Recession Defects and Gingival Phenotype , brought the most relevant prognostic factors into a single diagnostic matrix (Cortellini & Bissada, 2018; G. P. Pini Prato & Di Gianfilippo, 2020; G. P. Pini Prato et al, 2022) to ultimately suggest indications for treatment. Scientific papers were published to define the epidemiology of gingival recessions according to the new classification (Romandini et al, 2020) and to provide guidance on how to use it in clinical and research settings (G. P. Pini Prato & Di Gianfilippo, 2020).…”

“…Scientific papers were published to define the epidemiology of gingival recessions according to the new classification (Romandini et al, 2020) and to provide guidance on how to use it in clinical and research settings (G. P. Pini Prato & Di Gianfilippo, 2020). Studies are now being conducted to define the reproducibility of the diagnosis according to the new classification of gingival recessions (G. P. Pini Prato et al, 2022).…”

Acellular dermal matrix for the treatment of multiple gingival recession defects associated with carious and previously restored cervical lesions: A case report with 10 years of follow‐up

“…These measurements were recorded following independent classification systems in 2012, when the patient presented to periodontal examination for the first time. However, all these variables are today summarized in a single matrix known as the 2018 Classification of Gingival Recession Defects and Gingival Phenotype 1,24,25 . Accurate evaluation of recession characteristics, tooth structure, phenotype, and previous periodontal/restorative treatments was one of the keys for proper treatment planning.…”

Reliability assessment of the 2018 classification case definitions of peri‐implant health, peri‐implant mucositis, and peri‐implantitis

“…8 Recently, the reproducibility of the 2018 classification case definitions of periodontitis and of gingival recession defects and gingival phenotype has been assessed. [9][10][11][12] However, no previous study has assessed the reproducibility of the new case definitions of peri-implant health and diseases. Therefore, the purpose of this survey was to evaluate the agreement between examiners with different levels of education and expertise in assigning the 2018 classification case definitions to dental implants and their accuracy against a reference diagnosis.…”

“…As with any classification system, it is critical to estimate external validity of the 2018 classification case definitions when applied in research and clinical practice in order to prove they are exhaustive, non‐ambiguous, simple, and have high reproducibility 8 . Recently, the reproducibility of the 2018 classification case definitions of periodontitis and of gingival recession defects and gingival phenotype has been assessed 9–12 . However, no previous study has assessed the reproducibility of the new case definitions of peri‐implant health and diseases.…”