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Evidence-based, personalised and minimally invasive treatment for periodontitis patients - the new EFP S3-level clinical treatment guidelines

Abstract

The 2017 international classification system for periodontal diseases characterises periodontitis patients based upon disease extent, severity and past experience, and in stage IV includes a treatment complexity component. In addition, taking into account well-established risk factors, it aims to estimate the risk for future attachment loss. This classification system draws upon current understanding of disease pathobiology and reflects the complex, multifactorial nature of the periodontitis. It also acknowledges individual patients' risk profiles.

Classification and diagnosis are distinct but linked entities, and the inclusion of established risk factors in the system helps signpost the clinician and patient towards a more personalised approach to care provision. The European Federation of Periodontology (EFP) has recently developed an S3-level clinical treatment guideline for stages I to III periodontitis, based upon a rigorous standardised process involving 15 systematic reviews of current evidence and their synthesis by a representative group of experts and stakeholders. The aim is to guide the practitioner through the complex plethora of periodontal management options and to facilitate pragmatic decision-making in full knowledge of the evidence base.

Here, we present the structured, stepwise treatment protocols developed by the EFP guideline group and highlight selected specific clinical recommendations. The adapted guidelines for the UK healthcare system will be published in early 2021.

Key points

  • Presents the key clinical recommendations of the new European Federation for Periodontology (EFP) clinical practice guideline for the treatment of periodontitis. The guidelines adopt a stepwise approach to the treatment of periodontitis that is based on the new EFP/AAP classification of periodontal diseases.

  • These guidelines were developed using the internationally leading, high-quality S3-level approach, combining state-of-the-art evidence-gathering, assessment and synthesis with the combined clinical expertise of a broadly representative pan-discipline guideline group.

  • The reader will learn about the advantages of the novel guideline approach to develop solid and unbiased clinical recommendations, and will be able to adopt a high-level, stepwise framework for the treatment of periodontitis. The national implementation of these S3-level clinical guidelines by the British Society of Periodontology & Implant dentistry will be published in early 2021.

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Kebschull, M., Chapple, I. Evidence-based, personalised and minimally invasive treatment for periodontitis patients - the new EFP S3-level clinical treatment guidelines. Br Dent J 229, 443–449 (2020). https://doi.org/10.1038/s41415-020-2173-7

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