7
HERRERA ET AL .
and worldwide, (ii) reduce tooth loss associated with periodontitis, and ultimately (iii) improve overall systemic health and quality of life.
Scientific Medical Societies in Germany (AWMF) (https://www.awmf. org/leitlinien/awmf-regelwerk/awmf-guidance.html) and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) working group (https://www.gradeworkinggroup.org/). The guideline was developed under the auspices of the European Federation of Periodontology (EFP) and overseen by the EFP Work- shop Committee. This guideline development process was steered by an organizing committee and a methodology consultant designated by the EFP. All members of the organizing committee participated in the EFP workshop committee. To ensure adequate stakeholder involvement, the EFP established a guideline panel involving dental professionals representing national periodontal societies within the EFP, together with experts in ortho- dontics, prosthodontics, implant dentistry, oral surgery and oral diag- nosis (Table 1). These delegates were nominated and selected by the organizing committee and participated in the guideline development process with voting rights in the consensus conference. For the guide- line development process, delegates were assigned to four working groups that were chaired by selected members of the organizing com- mittee and guided by the methodology consultant. This panel was supported by key stakeholders from European scientific societies with a strong professional interest in periodontal care and from European organizations representing key groups within the dental profession (Table 2), and key experts from non-EFP member regions, such as North America and Australia. In addition, the EFP engaged an independent guideline methodol- ogist to advise the panel and facilitate the consensus process (Prof. Dr. med. Ina Kopp [I.K.]). The guideline methodologist had no voting rights. The EFP and the guideline panel attempted to involve patient forums/organizations but were unable to identify any groups focused on periodontal diseases at a pan-European level. In a future update, efforts will be undertaken to include the perspectives of citizens/ patients (Brocklehurst et al., 2018), and national societies will be encouraged to involve patient groups within individual countries, as key stakeholders for the Adaptation , Adoption , De Novo Development — “ ADOLOPMENT ” of this GPG (Schünemann et al., 2017).
2.1
Target users of the guideline
|
Dental professionals, together with stakeholders related to oral health care, including patients. In addition, this CPG aims to inform medical professions, health systems, policymakers, patients and the public.
2.2
Targeted environments
|
Academic/hospital environments, community-based dental clinics and practices were the targeted environments for this guideline.
2.3
Targeted patient population
|
Patients were selected based on the following criteria:
I. People with stage IV periodontitis. II. People with stage IV periodontitis, following successful peri- odontal treatment. III. People with stage IV periodontitis, following successful peri- odontal and multidisciplinary treatment.
2.4
Exceptions from the guideline
|
This guideline does not consider in detail the health/economic cost – benefit ratio of the proposed therapies, since (i) the target users and patient populations include people in different countries with diverse, not readily comparable healthcare systems, and (ii) there is a paucity of sound scientific data available addressing this issue. This guideline does not consider the treatment of gingivitis (although management of gingivitis is included as an indirect goal in a number of proposed interventions), the treatment of stages I – III periodontitis (already covered in a previously published guideline; Sanz, Herrera, et al., 2020), necrotising periodontitis (Herrera et al., 2018; Papapanou et al., 2018), periodontitis as manifestation of systemic diseases and mucogingival conditions (Jepsen et al., 2018). However, we emphasize that (i) treatment of gingivitis is a primary prevention strategy for peri- odontitis (Chapple et al., 2015), and (ii) maintenance of stable periodontal tissues requires the control of gingival inflammation (Chapple et al., 2018).
3.2
Evidence synthesis
|
3.2.1 | Systematic search and critical appraisal of guidelines
To assess and utilize existing guidelines during the development of the present guideline, we performed electronic searches in a range of well-established guideline registers and the websites of large peri- odontal societies: • Guideline International Network (GIN) • Guidelinecentral.com • The National Institute for Health and Clinical Excellence (NICE) • Canadian Health Technology Assessment (CADTH)
3
METHODOLOGY
|
3.1
General framework
|
This guideline was developed following methodological guidance pub- lished by the Standing Guideline Commission of the Association of
Made with FlippingBook Annual report