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R11.8. Does long-term SPC impact upon patient- reported outcome measures (PROMs) (OHRQoL, masticatory function, aesthetics)?
function and aesthetics appears to increase over the 9 years of SPC (graphical information available only).
Consistency Not applicable.
PICO question addressed by a SR
R11.8: Evidence-based statement We do not know if long-term SPC impacts upon patient-reported outcomes . Supporting literature (Leow et al., 2021) Quality of evidence Three prospective cohorts Grade of recommendation GradeO — $ Statement: unclear, additional research needed Strength of consensus Unanimous consensus (0% of the group abstained due to potential CoI)
Balance of benefit and harm Regular SPC benefits the patient to reduce the risk of tooth loss and CAL, while limited evidence exists on PROMs.
Overall certainty of the evidence Low.
From evidence to recommendation — additional considerations
Background
Intervention
Acceptability, feasibility, ethical, economic, legal considerations Not applicable.
The impact of a disease and its treatment on a patient's quality of life may be captured by PROMs. A number of tools have been uti- lized to assess PROMs, often in the form of questionnaires or scales. Periodontitis has been demonstrated to have a negative impact on a patient's OHRQoL, while non-surgical therapy and sur- gical therapy may improve this (Shanbhag et al., 2012), using vali- dated PROMs.
12 | IMPACT OF PERIODONTAL TREATMENT ON SYSTEMIC HEALTH AND QUALITY OF LIFE Periodontal treatment in severe periodontitis (stages III or IV or equivalent): Impact on systemic health and quality of life 12.1 | A systematic review (Orlandi et al., 2021) addressed the impact of periodontal interventions, including non-surgical (steps 1 and 2), surgi- cal (step 3) and adjunctive therapies, on systemic health and quality of life in patients with severe (stages III or IV or equivalent) periodonti- tiswho: 1. were systemically healthy by anamnesis (medical history); 2. exhibited one or more co-morbid systemic non-communicable dis- eases (NCDs); 3. were pregnant. NCDs assessed were: cardiovascular diseases, arrhythmias, hyper- tension, rheumatic, neurological, respiratory, metabolic, kidney, liver and inflammatory gastrointestinal diseases, malignancy, osteoporosis and mental health conditions (G.B.D. Diseases and Injuries Collaborators, 2020). The included intervention studies did not specifically provide treatment to patients to a defined endpoint/outcome of success; therefore, there may be an underestimation of the effect size upon the systemic outcomes defined by the PICOS. Furthermore, treat- ment of periodontitis is instigated for the purpose of improving oral health, and systemic health benefits in patients without a co-morbid NCD are therefore a secondary consideration because an absence
Available evidence
Number and design of included studies Three prospective cohorts reporting on PROMs were included.
Risk of bias All three studies were judged as, “ low ” risk of bias using the Newcastle – Ottawa scale. Effect sizes and their clinical relevance Patient-reported outcomes: the Italian translation of the OHIP-14 questionnaire was used in one RCT (Cortellini et al., 2020) at baseline, 1, 5 and 10 years after regenerative treatment (other treatment groups were not relevant to this review). The mean OHIP-14 score 1 year after the regenerative procedure was 6.6 (±2.4). However, no data were presented at 10 years. Other PROMs: 27 periodontal abscesses were reported in one RCT (Kaldahl et al., 1996a), with 84 months of follow-up, with most (85%) occurring in the group originally treated by coronal scaling alone and a large proportion (63%) occurring in sites with PPD ≥ 7mmat the initial examination. Cortellini et al. (2020) assessed masticatory function and aes- thetics using a 5-point Likert scale with a 10-year follow-up. The pro- portion of people reporting “ some concern ” for both masticatory
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