Evidence-based, personalised and minimally invasive treatment for periodontitis patients - the new EFP S3-level clinical treatment guidelines.
Journal
British dental journal
ISSN: 1476-5373
Titre abrégé: Br Dent J
Pays: England
ID NLM: 7513219
Informations de publication
Date de publication:
10 2020
10 2020
Historique:
received:
12
06
2020
accepted:
21
07
2020
entrez:
10
10
2020
pubmed:
11
10
2020
medline:
12
3
2021
Statut:
ppublish
Résumé
The 2017 international classification system for periodontal diseases characterises periodontitis patients based upon disease extent, severity and past experience, and in stage IV includes a treatment complexity component. In addition, taking into account well-established risk factors, it aims to estimate the risk for future attachment loss. This classification system draws upon current understanding of disease pathobiology and reflects the complex, multifactorial nature of the periodontitis. It also acknowledges individual patients' risk profiles.Classification and diagnosis are distinct but linked entities, and the inclusion of established risk factors in the system helps signpost the clinician and patient towards a more personalised approach to care provision. The European Federation of Periodontology (EFP) has recently developed an S3-level clinical treatment guideline for stages I to III periodontitis, based upon a rigorous standardised process involving 15 systematic reviews of current evidence and their synthesis by a representative group of experts and stakeholders. The aim is to guide the practitioner through the complex plethora of periodontal management options and to facilitate pragmatic decision-making in full knowledge of the evidence base.Here, we present the structured, stepwise treatment protocols developed by the EFP guideline group and highlight selected specific clinical recommendations. The adapted guidelines for the UK healthcare system will be published in early 2021.
Identifiants
pubmed: 33037364
doi: 10.1038/s41415-020-2173-7
pii: 10.1038/s41415-020-2173-7
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
443-449Références
GBD 2017 Disease and Injury Incidence and Prevalence Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet 2018; 392: 1789-1858.
GBD 2017 DALYs and HALE Collaborators. Global, regional, and national disability-adjusted life-years (DALYs) for 359 diseases and injuries and healthy life expectancy (HALE) for 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet 2018; 392: 1859-1922.
Lindhe J, Ranney R, Lamster I et al. Consensus Report: Chronic Periodontitis. Ann Periodontol 1999; 4: 38.
Lang N, Bartold P M, Cullinan M et al. Consensus Report: Aggressive Periodontitis. Ann Periodontol 1999; 4: 53.
Armitage G C, Cullinan M P, Seymour G J. Comparative biology of chronic and aggressive periodontitis: introduction. Periodontol 2000 2010; 53: 7-11.
Kebschull M, Guarnieri P, Demmer R T, Boulesteix A L, Pavlidis P, Papapanou P N. Molecular differences between chronic and aggressive periodontitis. J Dent Res 2013; 92: 1081-1088.
Kebschull M. Editorial: Is the Current Periodontitis Classification Supported by Pathophysiological Evidence? Oral Health Prev Dent 2017; 15: 405-406.
Caton J, Armitage G, Berglundh T et al. A new classification scheme for periodontal and peri-implant diseases and conditions - Introduction and key changes from the 1999 classification. J Clin Periodontol 2018; DOI: 10.1002/JPER.18-0157.
Tonetti M S, Greenwell H, Kornman K S. Staging and grading of periodontitis: Framework and proposal of a new classification and case definition. J Clin Periodontol 2018; DOI: 10.1111/jcpe.12945.
Papapanou P N, Sanz M, Buduneli N et al. Periodontitis: Consensus report of workgroup 2 of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions. J Clin Periodontol 2018; DOI: 10.1111/jcpe.12946.
Dietrich T, Ower P, Tank M et al. Periodontal diagnosis in the context of the 2017 classification system of periodontal diseases and conditions - implementation in clinical practice. Br Dent J 2019; 226: 16-22.
Walter C, Ower P, Tank M et al. Periodontal diagnosis in the context of the 2017 classification system of periodontal diseases and conditions: Presentation of a middle-aged patient with localised periodontitis. Br Dent J 2019; 226: 98-100.
Walter C, Chapple I L C, Ower P et al. Periodontal diagnosis in the context of the BSP implementation plan for the 2017 classification system of periodontal diseases and conditions: presentation of a patient with a history of periodontal treatment. Br Dent J 2019; 226: 265-267.
Walter C, Chapple I L C, Ower P et al. Periodontal diagnosis in the context of the BSP implementation plan for the 2017 classification system of periodontal diseases and conditions: presentation of a patient with severe periodontitis following successful periodontal therapy and supportive periodontal treatment. Br Dent J 2019; 226: 411-413.
Walter C, Chapple I L C, Ower P et al. Periodontal diagnosis in the context of the BSP implementation plan for the 2017 classification system of periodontal diseases and conditions: presentation of a pair of young siblings with periodontitis. Br Dent J 2019; 226: 23-26.
Wadia R, Walter C, Chapple I L C et al. Periodontal diagnosis in the context of the 2017 classification system of periodontal diseases and conditions: presentation of a patient with periodontitis localised to the molar teeth. Br Dent J 2019; 226: 180-182.
Balshem H, Helfand M, Schünemann H J et al. GRADE guidelines: 3. Rating the quality of evidence. J Clin Epidemiol 2011; 64: 401-406.
Schünemann H J, Zhang Y, Oxman A D, Expert Evidence in Guidelines Group. Distinguishing opinion from evidence in guidelines. BMJ 2019; DOI: 10.1136/bmj.l4606.
Sanz M, Herrera D, Kebschull M et al. Treatment of Stage II II PeriodontitisThe EFP S3 Level Clinical Practice Guideline. J Clin Periodontol 2020; 47 Suppl 22: 4-60.
Loos B, Needleman I. Endpoints of active periodontal therapy. J Clin Periodontol 2020; 47 Suppl 22: 61-71.
Teughels W, Feres M, Oud V, Martín C, Matesanz P, Herrera D. Adjunctive effect of systemic antimicrobials in periodontitis therapy. A systematic review and meta-analysis. J Clin Periodontol 2020; 47 Suppl 22: 257-281.
Suvan J, Leira Y, Moreno F, Graziani F, Derks J, Tomasi C. Subgingival Instrumentation for Treatment of Periodontitis. A Systematic Review. J Clin Periodontol 2020; 47 Suppl 22: 155-175.
Sanz-Sánchez I, Montero E, Citterio F, Romano F, Molina A, Aimetti M. Efficacy of access flap procedures compared to subgingival debridement in the treatment of periodontitis. A systematic review and meta-analysis. J Clin Periodontol 2020; 47 Suppl 22: 282-302.
Salvi G E, Stähli A, Schmidt J C, Ramseier C A, Sculean A, Walter C. Adjunctive laser or antimicrobial photodynamic therapy to non-surgical mechanical instrumentation in patients with untreated periodontitis. A systematic review and meta-analysis. J Clin Periodontol 2020; 47 Suppl 22: 176-198.
Ramseier C A, Woelber J P, Kitzmann J, Detzen L, Carra M C, Bouchard P. Impact of risk factor control interventions for smoking cessation and promotion of healthy lifestyles in patients with periodontitis: a systematic review. J Clin Periodontol 2020; 47 Suppl 22: 90-106.
Polak D, Wilensky A, Antonoglou G N, Shapira L, Goldstein M, Martin C. The Efficacy of Pocket Elimination/Reduction Compared to Access Flap Surgery: A Systematic Review and Meta-analysis. J Clin Periodontol 2020; 47 Suppl 22: 303-319.
Nibali L, Koidou V P, Nieri M, Barbato L, Pagliaro U, Cairo F. Regenerative surgery versus access flap for the treatment of intrabony periodontal defects. A systematic review and meta-analysis. J Clin Periodontol 2020; 47 Suppl 22: 320-351.
Jepsen S, Gennai S, Hirschfeld J, Kalemaj Z, Buti J, Graziani F. Regenerative surgical treatment of furcation defects: A systematic review and Bayesian network meta-analysis of randomized clinical trials. J Clin Periodontol 2020; 47 Suppl 22: 352-374.
Herrera D, Matesanz P, Martín C, Oud V, Feres M, Teughels W. Adjunctive effect of locally delivered antimicrobials in periodontitis therapy. A systematic review and meta-analysis. J Clin Periodontol 2020; 47 Suppl 22: 239-256.
Figuero E, Roldán S, Serrano J, Escribano M, Martín C, Preshaw P M. Efficacy of adjunctive therapies in patients with gingival inflammation. A systematic review and meta-analysis. J Clin Periodontol 2020; 47 Suppl 22: 125-143.
Donos N, Calciolari E, Brusselaers N, Goldoni M, Bostanci N, Belibasakis G. The adjunctive use of host modulators in non-surgical periodontal therapy. A systematic review of randomized, placebo-controlled clinical studies. J Clin Periodontol 2020; 47 Suppl 22: 199-238.
Dommisch H, Walter C, Dannewitz B, Eickholz P. Resective surgery for the treatment of furcation involvement - a systematic review. J Clin Periodontol 2020; 47 Suppl 22: 375-391.
Carra M C, Detzen L, Kitzmann J, Woelber J P, Ramseier C A, Bouchard P. Promoting behavioural changes to improve oral hygiene in patients with periodontal diseases: a systematic review. J Clin Periodontol 2020; 47 Suppl 22: 72-89.
Slot D, Valkenburg C, van der Weijden F. Mechanical plaque removal of periodontal maintenance patientsA Systematic Review and Network Meta-Analysis. J Clin Periodontol 2020; 47 Suppl 22: 107-124.
Trombelli L, Farina R, Pollard A et al. Efficacy of alternative or additional methods to professional mechanical plaque removal during supportive periodontal therapy. A systematic review and meta-analysis. J Clin Periodontol 2020; 47 Suppl 22: 144-154.
Chapple I L C, Mealey B L, Van Dyke T E et al. Periodontal health and gingival diseases and conditions on an intact and a reduced periodontium: Consensus report of workgroup 1 of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions. J Clin Periodontol 2018; DOI: 10.1111/jcpe.12940.
NHS England and NHS Improvement. Commissioning Standard: Dental Care for People with Diabetes. 2019. Available at https://www.england.nhs.uk/wp-content/uploads/2019/08/commissioning-standard-dental-care-for-people.pdf (accessed September 2020).
Schünemann H J, Wiercioch W, Brozek J et al. GRADE Evidence to Decision (EtD) frameworks for adoption, adaptation, and de novo development of trustworthy recommendations: GRADE-ADOLOPMENT. J Clin Epidemiol 2017; 81: 101-110.