Treatment of pulpal and apical disease: The European Society of Endodontology (ESE) S3-level clinical practice guideline.
apical periodontitis
clinical guideline
diagnosis
pulpitis
tooth survival
Journal
International endodontic journal
ISSN: 1365-2591
Titre abrégé: Int Endod J
Pays: England
ID NLM: 8004996
Informations de publication
Date de publication:
Oct 2023
Oct 2023
Historique:
revised:
25
08
2023
received:
18
08
2023
accepted:
26
08
2023
medline:
23
10
2023
pubmed:
29
9
2023
entrez:
29
9
2023
Statut:
ppublish
Résumé
The ESE previously published quality guidelines for endodontic treatment in 2006; however, there have been significant changes since not only in clinical endodontics but also in consensus and guideline development processes. In the development of the inaugural S3-level clinical practice guidelines (CPG), a comprehensive systematic and methodologically robust guideline consultation process was followed in order to produce evidence-based recommendations for the management of patients presenting with pulpal and apical disease. To develop an S3-level CPG for the treatment of pulpal and apical disease, focusing on diagnosis and the implementation of the treatment approaches required to manage patients presenting with pulpitis and apical periodontitis (AP) with the ultimate goal of preventing tooth loss. This S3-level CPG was developed by the ESE, with the assistance of independent methodological guidance provided by the Association of Scientific Medical Societies in Germany and utilizing the GRADE process. A robust, rigorous and transparent process included the analysis of relevant comparative research in 14 specifically commissioned systematic reviews, prior to evaluation of the quality and strength of evidence, the formulation of specific evidence and expert-based recommendations in a structured consensus process with leading endodontic experts and a broad base of external stakeholders. The S3-level CPG for the treatment of pulpal and apical disease describes in a series of clinical recommendations the effectiveness of diagnosing pulpitis and AP, prior to investigating the effectiveness of endodontic treatments in managing those diseases. Therapeutic strategies include the effectiveness of deep caries management in cases with, and without, spontaneous pain and pulp exposure, vital versus nonvital teeth, the effectiveness of root canal instrumentation, irrigation, dressing, root canal filling materials and adjunct intracanal procedures in the management of AP. Prior to treatment planning, the critical importance of history and case evaluation, aseptic techniques, appropriate training and re-evaluations during and after treatment is stressed. The first S3-level CPG in endodontics informs clinical practice, health systems, policymakers, other stakeholders and patients on the available and most effective treatments to manage patients with pulpitis and AP in order to preserve teeth over a patient's lifetime, according to the best comparative evidence currently available.
Sections du résumé
BACKGROUND
BACKGROUND
The ESE previously published quality guidelines for endodontic treatment in 2006; however, there have been significant changes since not only in clinical endodontics but also in consensus and guideline development processes. In the development of the inaugural S3-level clinical practice guidelines (CPG), a comprehensive systematic and methodologically robust guideline consultation process was followed in order to produce evidence-based recommendations for the management of patients presenting with pulpal and apical disease.
AIM
OBJECTIVE
To develop an S3-level CPG for the treatment of pulpal and apical disease, focusing on diagnosis and the implementation of the treatment approaches required to manage patients presenting with pulpitis and apical periodontitis (AP) with the ultimate goal of preventing tooth loss.
METHODS
METHODS
This S3-level CPG was developed by the ESE, with the assistance of independent methodological guidance provided by the Association of Scientific Medical Societies in Germany and utilizing the GRADE process. A robust, rigorous and transparent process included the analysis of relevant comparative research in 14 specifically commissioned systematic reviews, prior to evaluation of the quality and strength of evidence, the formulation of specific evidence and expert-based recommendations in a structured consensus process with leading endodontic experts and a broad base of external stakeholders.
RESULTS
RESULTS
The S3-level CPG for the treatment of pulpal and apical disease describes in a series of clinical recommendations the effectiveness of diagnosing pulpitis and AP, prior to investigating the effectiveness of endodontic treatments in managing those diseases. Therapeutic strategies include the effectiveness of deep caries management in cases with, and without, spontaneous pain and pulp exposure, vital versus nonvital teeth, the effectiveness of root canal instrumentation, irrigation, dressing, root canal filling materials and adjunct intracanal procedures in the management of AP. Prior to treatment planning, the critical importance of history and case evaluation, aseptic techniques, appropriate training and re-evaluations during and after treatment is stressed.
CONCLUSION
CONCLUSIONS
The first S3-level CPG in endodontics informs clinical practice, health systems, policymakers, other stakeholders and patients on the available and most effective treatments to manage patients with pulpitis and AP in order to preserve teeth over a patient's lifetime, according to the best comparative evidence currently available.
Types de publication
Journal Article
Review
Langues
eng
Pagination
238-295Subventions
Organisme : European Society of Endodontology (ESE)
Investigateurs
Marta Adam
(M)
Ana Arias
(A)
Carsten Appel
(C)
Kathrin Becker
(K)
Sema Belli
(S)
Cecilia Bourguignon
(C)
Christos Boutsioukis
(C)
Sebastian Bürklein
(S)
Charlotte Carter
(C)
Antonis Chaniotis
(A)
Stefano Corbella
(S)
Valerie Chevalier
(V)
Elisabetta Cotti
(E)
Till Dammaschke
(T)
Roeland De Moor
(R)
Paul Dummer
(P)
Ken Eaton
(K)
Fernando Durán-Sindreu
(F)
Vittorio Franco
(V)
Helena Fransson
(H)
Gianluca Gambarini
(G)
Antonio Ginjeira
(A)
Aleksandar Jakovljevic
(A)
Amanda Jackson
(A)
Anastasia Kossioni
(A)
Casper Kruse
(C)
Maarten Meire
(M)
Paulo Melo
(P)
Nastaran Meschi
(N)
Giampiero Rossi-Fedele
(G)
Chiara Pirani
(C)
Barry Quinn
(B)
Tina Rödig
(T)
Eyal Rosen
(E)
Edgar Schäfer
(E)
Hagay Shemesh
(H)
Christian Spleith
(C)
Jale Tanalp
(J)
Igor Tsesis
(I)
Leo Tjäderhane
(L)
Phil Tomson
(P)
Nicola West
(N)
John Whitworth
(J)
Ina Kopp
(I)
Informations de copyright
© 2023 The Authors. International Endodontic Journal published by John Wiley & Sons Ltd on behalf of British Endodontic Society.
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