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SANZ et al .
Background
(PDT) with a 0.01% methylene blue as photosensitizer and a diode laser (wavelength of 660 nm) (Carvalho et al., 2015). No statistically significant differences were observed in any study, although CAL gain was more relevant with adjunctive PDT (1.54 mm) in compari - son with conventional PMPR alone (0.96 mm). The systematic review presented at this Workshop provided information, based on meta- analysis, of the possible effects of the alternative/adjunctive methods mentioned, with no significant difference for the primary outcome (CAL changes), after 12-month follow-up, amounting −0.233 mm (95% CI [−1.065; 0.598; p = .351), favouring the control groups. Economic considerations For the adjunctive use of SDD, adverse effects and cost–benefit ratio have to be considered. For the adjunctive use of PDT, a previous systematic review (Xue et al., 2017), which included 11 RCTs, found better results for PDT, but only after 3 months, with 0.13 mm of ad - ditional impact in PPD reduction. No increase in adverse events were reported. Cost–benefit or cost-effective analyses are missing and may be very relevant when considering this specific treatment option.
Intervention The systematic review (Trombelli et al., 2015) was retrieving avail - able RCTs on any given alternative intervention to conventional PMPR (the latter including supragingival and/or subgingival removal of plaque, calculus and debris performed with manual and/or pow - ered instruments) in the maintenance of periodontitis patients with a follow-up of at least 1 year following the first administration of intervention/control treatment. Available evidence In the systematic review (Trombelli et al., 2020), only one RCT was identified, assessing Er:YAG laser as an alternative method to con - ventional PMPR. No statistically significant differences were found (Krohn-Dale, Boe, Enersen, & Leknes, 2012). Economic considerations Cost-benefit or cost-effective analyses are missing and may be very relevant when considering this specific treatment option. The same is true for PROMs. R4.16 | Should adjunctive methods be used for professional mechanical plaque removal (PMPR) in supportive periodontal care? Evidence-based recommendation (4.16) We suggest not to use adjunctive methods (sub-antimicrobial dose doxycycline, photodynamic therapy) to professional mechanical plaque removal (PMPR) in supportive periodontal care. Supporting literature Trombelli et al. (2020) Quality of evidence Two RCTs Grade of recommendation Grade B—↓ Strength of consensus Strong consensus (2.7% of the group abstained due to potential CoI)
8.5 | Intervention: Risk factor control
R4.17 | What is the value of risk factor control in SPC?
Expert consensus-based recommendation (4.17) We recommend risk factor control interventions in periodontitis patients in supportive periodontal care. Supporting literature Ramseier et al. (2020) Grade of recommendation Grade A—↑↑ Strength of consensus Strong consensus (0% of the group abstained due to potential CoI)
Background
Intervention Periodontitis patients benefit from additional risk factor control in - terventions to improve the maintenance of periodontal stability. Interventions include patient education which be staged and adapted according to individual needs ranging from single brief advice to pa - tient referral for advanced counselling and pharmacotherapy. Smoking and diabetes are two of the main risk factors for periodontitis, and they are currently included in the grading of periodontitis (Papapanou et al., 2018). Controlling these risk factors therefore would be critical for treatment response and for long-term stability. In addition, other relevant factors, part a healthy life-style counselling, are considered, including dietary counselling, physical exercise or weight loss. These interventions, together with those for tobacco cessation and diabe - tes control, are not direct responsibility of oral health professionals, and they may want to refer the patients to other health professionals. However, the direct/indirect role of oral health professionals in these interventions should be emphasized.
Background
Intervention The systematic review (Trombelli et al., 2015) was retrieving avail - able RCTs on any given additional intervention to conventional PMPR (the latter including supragingival and/or subgingival removal of plaque, calculus and debris performed with manual and/or pow - ered instruments) in the maintenance of periodontitis patients with a follow-up of at least 1 year following the first administration of intervention/control treatment. Available evidence In the systematic review (Trombelli et al., 2020), two RCTs were iden - tified, one testing sub-antimicrobial dose (20 mg b.i.d.) of doxycycline (Reinhardt et al., 2007), another evaluating photodynamic therapy
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