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with periodontitis stages I to III. Its main objective is therefore to support the evidence-based recommendations for the different in - terventions used at the different steps of periodontal therapy, based on the best available evidence and/or expert consensus. In so doing, this guideline aims to improve the overall quality of periodontal treatment in Europe, reduce tooth loss associated with periodontitis and ultimately improve overall systemic health and quality of life. A separate guideline covering the treatment of Stage IV periodontitis will be published.
Evaluation (GRADE) Working Group (https://www.gradeworkinggro up.org/). The guideline was developed under the auspices of the European Federation of Periodontology (EFP) and overseen by the EFP Workshop Committee. This guideline development process was steered by an Organizing Committee and a group of methodology consultants designated by the EFP. All members of the Organizing Committee were part of the EFP Workshop Committee. To ensure adequate stakeholder involvement, the EFP estab - lished a guideline panel involving dental professionals representing 36 national periodontal societies within the EFP (Table 1a). These delegates were nominated, participated in the guideline development process and had voting rights in the consensus con - ference. For the guideline development process, delegates were as - signed to four Working Groups that were chaired by the members of the Organizing Committee and advised by the methodology consul - tants. This panel was supported by key stakeholders from European scientific societies with a strong professional interest in periodon - tal care and from European organizations representing key groups within the dental profession, and key experts from non-EFP member countries, such as North America (Table 1b). In addition, EFP engaged an independent guideline methodolo - gist to advise the panel and facilitate the consensus process (Prof. Dr. med. Ina Kopp). The guideline methodologist had no voting rights. EFP and the guideline panel tried to involve patient organizations but were not able to identify any regarding periodontal diseases at European level. In a future update, efforts will be undertaken to in - clude the perspective of citizens/patients (Brocklehurst et al., 2018).
2.1 | Target users of the guideline
Dental and medical professionals, together with all stakeholders re - lated to health care, particularly oral health, including patients.
2.2 | Targeted environments
Dental and medical academic/hospital environments, clinics and practices.
2.3 | Targeted patient population
People with periodontitis stages I to III. People with periodontitis stages I to III following successful treatment.
2.4 | Exceptions from the guideline
3.2 | Evidence synthesis
3.2.1 | Systematic search and critical appraisal of guidelines
This guideline did not consider the health economic cost–benefit ratio, since (a) it covers multiple different countries with disparate, not readily comparable health systems, and (b) there is a paucity of sound scientific evidence available addressing this question. This guideline did not consider the treatment of gingivitis (although management of gingivitis is considered as an indirect goal in some interventions evaluated), the treatment of Stage IV periodontitis, necrotising periodontitis, periodontitis as manifestation of systemic diseases and mucogingival conditions.
To assess and utilize existing guidelines during the development of the present guideline, well-established guideline registers and the websites of large periodontal societies were electronically searched for potentially applicable guideline texts: • Guideline International Network (GIN) • www.Guidelinecentral.com • The National Institute for Health and Clinical Excellence (NICE)
3 | METHODOLOGY
• Canadian Health Technology Assessment (CADTH) • European Federation for Periodontology (EFP) • American Academy of Periodontology (AAP) • American Dental Association (ADA)
3.1 | General framework
This guideline was developed following methodological guidance published by the Standing Guideline Commission of the Association of Scientific Medical Societies in Germany (AWMF) (https://www. awmf.org/leitlinien/awmf-regelwerk/awmf-guidance.html) and the Grading of Recommendations Assessment, Development and
The last search was performed on 30 September 2019. Search terms used were “periodont*,” “Periodontal,” “Guidelines” and “Clinical Practice Guidelines.” In addition, content was screened by hand searches. See Table 2.
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