Management of Acute Periodontal Conditions—The EFP S2k Level Clinical Practice Guideline
Abstract
BACKGROUND: The European Federation of Periodontology (EFP) has developed Clinical Practice Guidelines (CPGs) for the treatment of periodontitis and for the management of peri-implant diseases. In accordance with the 2018 Classification, acute periodontal conditions are characterised by rapid-onset pain or discomfort, tissue destruction and infection. Therefore, the development of a CPG to guide patients and clinicians in their management is justified. AIM: To develop an S2k-level CPG for the management of acute periodontal conditions, necrotising periodontal diseases, periodontal abscesses and acute manifestations of endodontic-periodontal lesions. METHODS: This S2k-level CPG was developed by the EFP, following methodological guidance from the Association of Scientific Medical Societies in Germany and the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) process. A rigorous and transparent process included synthesis of relevant research in two commissioned systematic reviews, evaluation of the quality and strength of evidence, formulation of specific recommendations and a structured consensus process involving leading experts and a broad base of stakeholders. Recommendations were based on the best available evidence, combined with structured expert consensus, particularly in areas where direct evidence remains scarce. RESULTS: The S2k-level CPG for the management of acute periodontal conditions presents a structured approach, grouping the recommendations in three successive steps: (1) confirming diagnosis, following the case definitions of the 2018 classification; (2) initial treatment, to control the acute condition including pain and active tissue destruction; and (3) subsequent treatments, to manage the pre-existing conditions and prevent the risk of disease recurrence and/or control the potential sequelae. CONCLUSION: The present S2k-level CPG informs clinical practice, health systems, policymakers and, indirectly, the public on the available and most effective interventions in the management of acute periodontal conditions.
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Authors: David Herrera, Panos N. Papapanou, Iain Chapple, Moritz Kebschull, Wim Teughels, Maurizio S. Tonetti, Mariano Sanz, Anton Sculean, Mario Aimetti, Ivan Alajbeg, Georgios Belibasakis, Juan Blanco, Ellen Bol - van den Hil, Nagihan Bostancı, Philippe Bouchard, Darko Božić, Nurcan Buduneli, Dagmar Fossa Bunæs, Elena Calciolari, Maria Clotilde Carra, laura ceballos, Tali Chackartchi, Raluca Cosgarea, monique danser, Jan Derks, Nicola Discepoli, Henrik Dommisch, Nikolaos Donos, Christoph Dörfer, Peter Eickholz, Bahar Eren Kuru, Ricardo Faria-Almeida, Roberto Fariña, Elena Figuero, helena francisco, helena frannson, maria geisinger, Moshe Goldstein, Marjolaine Gosset, Filippo Graziani, Ulvi K. Gursoy, Sören Jepsen, Niklaus P. Lang, Bruno G Loos, Rodrigo López, Phoebus Madianos, Paula Matesanz, marco meleti, Joerg Meyle, michele davide mignogna, A. Molina, Eduardo Montero, Luigi Nibali, Andrea Pilloni, Ioannis Polyzois, Philip Preshaw, Mia Rakic, Nerea Sánchez, Ignacio Sanz Sánchez, Lior Shapira, Dagmar Else Slot, Andreas Stavropoulos, jean suvan, Selena Toma, Cristiano Tomasi, Leonardo Trombelli, fridus van der Weijden, spyros vassilopoulos, Nicola X West, Asaf Wilensky, Peter Windisch, ezgi yesiltan, Evangelia Zampa, Methodological Consultant
Institutions: Shanghai Jiao Tong University, Karolinska Institutet, Columbia University, Universidade do Porto, Vrije Universiteit Amsterdam, University of Alabama at Birmingham, KU Leuven, Universidad Complutense de Madrid, Semmelweis University, University of Dundee, University of Glasgow, University of Amsterdam, Université Paris Cité, Sorbonne Université, University of Bern, University of Turku, Malmö University, Cliniques Universitaires Saint-Luc, Ege University, Justus-Liebig-Universität Gießen, Humboldt-Universität zu Berlin, University of Lisbon, University of Parma, Federico II University Hospital, University of Birmingham, University of Gothenburg, Goethe University Frankfurt, Hebrew University of Jerusalem, University of Turin, Sapienza University of Rome, Queen Mary University of London, University of Naples Federico II, Birmingham City University, University of Pisa, National and Kapodistrian University of Athens, King's College London, Shanghai Ninth People's Hospital, University of Bergen, University of Zagreb, University of Ferrara, Yeditepe University, Universidade de Santiago de Compostela, Universidad Rey Juan Carlos, Hadassah Medical Center, University of Siena, University Hospital Bonn, Christian-Albrechts-Universität zu Kiel, Academic Center for Dentistry Amsterdam, Dublin Dental University Hospital, NIHR Birmingham Biomedical Research Centre, Hôpital Rothschild, Birmingham Community Healthcare NHS Trust, University Of Bristol Dental Hospital, American Dental Hygienists' Association, Laboratory Orofacial Pathologies, Imaging and Biotherapies, Giessen School of Theology