ABSTRACT
Abstract The aim of this systematic review was to evaluate the methodological quality and the consistency of recommendations of clinical practice guidelines (CPGs) in Periodontology. An electronic search was conducted in two databases, MEDLINE and EMBASE, eight CPGs databases, and home pages of scientific societies in Periodontology up to April 2022. Three reviewers independently assessed methodological quality using the AGREE II instrument. In addition, we evaluated the consistency of the recommendations. Eleven CPGs were included, and the topics developed focused on prevention, diagnosis, risk factors, surgical and non-surgical periodontal treatment, antimicrobial therapy, root coverage, and maintenance. We found that the AGREE domains 2 (Stakeholder involvement) and 5 (Applicability) obtained the lowest scores. Domains 1 (Scope and purpose), 3 (Rigor of development) and 4 (Clarity of presentation) obtained the highest scores among the evaluated CPGs. The clinical recommendations for treatment of periodontal diseases were mostly consistent. Overall, the quality of CPGs used in periodontics was high. There was consistency of recommendations in specific fields. These findings may help researchers to promote CPGs focused on different fields of periodontics that have not yet been developed. Furthermore, the clinician will be able to make better clinical decisions.
ABSTRACT
Introducción: El mantenimiento regular es esencial para el éxito a largo plazo de la terapia periodontal. Pocos estudios han evaluado el nivel de cumplimiento a la fase de mantenimiento periodontal considerando características clínicas y complejidad del tratamiento recibido. Lapresente investigación busca evaluar la prevalencia y factores asociados al cumplimiento del mantenimiento periodontal en pacientes del Servicio de Periodoncia de la Clínica Dental Cayetano Heredia. Materiales y Métodos: Se registraron todas las historias clínicas disponibles de pacientes que habían recibido tratamiento y que necesitaron alguna terapia de mantenimiento periodontaldurante el periodo 2000-2005. Se evaluaron a) género b) severidad de enfermedad: representadaspor presencia o no de lesiones de furcación y piezas ausentes por motivos periodontales y c) tipo de tratamiento recibido: fase inicial, tratamientos quirúrgicos no regenerativos, tratamientos quirúrgicos regenerativos, injertos gingivales, injertos óseos e implantes dentales. Resultados:La prevalencia de pacientes que acudieron a mantenimiento fue del 10,9%; 39 pacientes, mientras que 320 pacientes culminaron tratamiento sin acudir a mantenimiento. Los tratamientos con injertos óseos e implantes dentales resultaron estadísticamente significativos (p?0,5)al cumplimiento del mantenimiento periodontal. Conclusiones: Pocos pacientes que han recibido tratamiento acuden al mantenimiento periodontal, siendo los tratados con injertos óseos enbloque y/o implantes dentales los que más valoraron la fase de mantenimiento periodontal comparado a otros, quizás debido a la naturaleza compleja de su tratamiento. No se encontraronasociaciones con respecto al género y a la severidad de la enfermedad.
Introduction: Regular maintenance is essential for a long term success of periodontal therapy. Few studies have evaluated the level of accomplishment in periodontal maintenance taking inconsideration clinical characteristics and the complexity of the treatment. The present investigation evaluates the prevalence and the factors associated with periodontal maintenance in patients at Cayetano Heredia University, Department of Periodontics. Materials and Methods: All the clinical histories available were registered from patients who had received treatment and that needed some periodontal maintenance therapy during the period 2000-2005. There were evaluated: a) gender b) severity of the disease (represented by presence or not of furcation involvement and tooth loss as a result of periodontal disease) c), type of received treatment:initial phase, non-regenerative surgical treatments, regenerative surgical treatments, soft tissue grafting, bone grafts and dental implants. Results: The prevalence of patients who enter to themaintenance phase was of 10.9%, 39 patients, where as 320 patients culminated their treatment without going to the maintenance phase. The treatments with bony grafts and dental implants were statistically significant (p?0.5) at the end of the periodontal maintenance phase. Conclusions: Few patients who had received treatment enter to the periodontal maintenance phase. From this group, the patients who were treated with bone grafts in blocks and/or dental implants were the ones that valued more the periodontal maintenance phase, maybe because of the complexity of the treatment. There were not found any relation between the gender and the severity of the disease.