Pipeline Intermediates
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Rule-Based Staging Explainability Trace
Clinical Consensus Audit
Cases Pending Processing
The main evaluation flow only cycles through cases with 100% full data.
AAP/EFP 2018 Consensus Staging Protocol
Official Consensus Guidelines for Periodontitis Staging & Classification
| Periodontitis Stage | Radiographic Bone Loss (RBL) | Clinical Attachment Loss (CAL) | Tooth Loss (due to perio) | Complexity & Local Factors |
|---|---|---|---|---|
| Stage 0 / Health | Crest within ≤ 2.0 mm of CEJ (Net RBL < 1.0 mm) | 0 mm (intact periodontium) | 0 teeth lost | Physiological bone architecture, intact lamina dura, no bleeding on probing |
| Stage I (Mild) | Net RBL 1.0 – 2.5 mm (< 15% root length, coronal third) | 1 – 2 mm interdental CAL | 0 teeth lost due to periodontitis | Maximum probing depth ≤ 4 mm; primarily horizontal bone loss; no furcation |
| Stage II (Moderate) | Net RBL 2.5 – 4.5 mm (15% – 33% coronal third) | 3 – 4 mm interdental CAL | 0 teeth lost due to periodontitis | Maximum probing depth ≤ 5 mm; primarily horizontal bone loss; minimal furcation |
| Stage III (Severe) | Net RBL ≥ 4.5 mm (≥ 33% extending to mid/apical root third) | ≥ 5 mm interdental CAL | ≤ 4 teeth lost due to periodontitis | Probing depth ≥ 6 mm; vertical bone loss ≥ 3 mm; Class II/III furcation; moderate ridge defect |
| Stage IV (Advanced) | Net RBL ≥ 4.5 mm (extending to mid/apical root third) | ≥ 5 mm interdental CAL | ≥ 5 teeth lost (≤ 19 teeth remaining) | Masticatory dysfunction, secondary occlusal trauma, mobile teeth, bite collapse, < 10 opposing pairs |
Key Clinical Diagnostic Rules:
- Primary Determinant: The single worst interdental bone loss site governs initial stage assignment.
- Multi-Site Confirmation Rule: Severe loss (Stage III/IV) must be confirmed by a second qualifying site to differentiate generalized periodontitis from localized artifacts or endo-perio lesions.
- Biological Normal Deduction: 2.0 mm is subtracted from radiographic CEJ-to-crest measurements because the physiological alveolar crest lies 1.5–2.0 mm apical to the CEJ.
- Dentition Threshold: Cases with ≤ 19 remaining teeth and confirmed Stage III loss are automatically classified as Stage IV.
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