Management of Acute Periodontal Conditions-The EFP S2k Level Clinical Practice Guideline.

BACKGROUND

The European Federation of Periodontology (EFP) has developed Clinical Practice Guidelines (CPGs) for the treatment of periodontitis and for the management of peri-implant diseases. In accordance with the 2018 Classification, acute periodontal conditions are characterised by rapid-onset pain or discomfort, tissue destruction and infection. Therefore, the development of a CPG to guide patients and clinicians in their management is justified.

AIM: To develop an S2k-level CPG for the management of acute periodontal conditions, necrotising periodontal diseases, periodontal abscesses and acute manifestations of endodontic-periodontal lesions.

METHODS

This S2k-level CPG was developed by the EFP, following methodological guidance from the Association of Scientific Medical Societies in Germany and the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) process. A rigorous and transparent process included synthesis of relevant research in two commissioned systematic reviews, evaluation of the quality and strength of evidence, formulation of specific recommendations and a structured consensus process involving leading experts and a broad base of stakeholders. Recommendations were based on the best available evidence, combined with structured expert consensus, particularly in areas where direct evidence remains scarce.

RESULTS

The S2k-level CPG for the management of acute periodontal conditions presents a structured approach, grouping the recommendations in three successive steps: (1) confirming diagnosis, following the case definitions of the 2018 classification; (2) initial treatment, to control the acute condition including pain and active tissue destruction; and (3) subsequent treatments, to manage the pre-existing conditions and prevent the risk of disease recurrence and/or control the potential sequelae.

CONCLUSION

The present S2k-level CPG informs clinical practice, health systems, policymakers and, indirectly, the public on the available and most effective interventions in the management of acute periodontal conditions.