种植体周围病的预防和治疗——EFP S3 级临床实践指南。
Prevention and treatment of peri-implant diseases-The EFP S3 level clinical practice guideline.
机构信息
ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group, University Complutense of Madrid, Madrid, Spain.
Department of Periodontology, Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
出版信息
J Clin Periodontol. 2023 Jun;50 Suppl 26:4-76. doi: 10.1111/jcpe.13823. Epub 2023 Jun 4.
BACKGROUND
The recently published Clinical Practice Guidelines (CPGs) for the treatment of stages I-IV periodontitis provided evidence-based recommendations for treating periodontitis patients, defined according to the 2018 classification. Peri-implant diseases were also re-defined in the 2018 classification. It is well established that both peri-implant mucositis and peri-implantitis are highly prevalent. In addition, peri-implantitis is particularly challenging to manage and is accompanied by significant morbidity.
AIM
To develop an S3 level CPG for the prevention and treatment of peri-implant diseases, focusing on the implementation of interdisciplinary approaches required to prevent the development of peri-implant diseases or their recurrence, and to treat/rehabilitate patients with dental implants following the development of peri-implant diseases.
MATERIALS AND METHODS
This S3 level CPG was developed by the European Federation of Periodontology, following methodological guidance from the Association of Scientific Medical Societies in Germany and the Grading of Recommendations Assessment, Development and Evaluation process. A rigorous and transparent process included synthesis of relevant research in 13 specifically 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.
RESULTS
The S3 level CPG for the prevention and treatment of peri-implant diseases culminated in the recommendation for implementation of various different interventions before, during and after implant placement/loading. Prevention of peri-implant diseases should commence when dental implants are planned, surgically placed and prosthetically loaded. Once the implants are loaded and in function, a supportive peri-implant care programme should be structured, including periodical assessment of peri-implant tissue health. If peri-implant mucositis or peri-implantitis are detected, appropriate treatments for their management must be rendered.
CONCLUSION
The present S3 level CPG informs clinical practice, health systems, policymakers and, indirectly, the public on the available and most effective modalities to maintain healthy peri-implant tissues, and to manage peri-implant diseases, according to the available evidence at the time of publication.
背景
最近发布的《牙周病治疗临床实践指南》(CPGs)为牙周炎患者提供了循证推荐,这些患者是根据 2018 年的分类定义的。2018 年的分类还重新定义了种植体周围疾病。众所周知,种植体周围黏膜炎和种植体周围炎的发病率都很高。此外,种植体周围炎的治疗特别具有挑战性,并且伴随着显著的发病率。
目的
制定一份针对种植体周围疾病预防和治疗的 S3 级临床实践指南,重点是实施跨学科方法,以预防种植体周围疾病的发展或其复发,并在发生种植体周围疾病后对种植体患者进行治疗/康复。
材料和方法
本 S3 级临床实践指南由欧洲牙周病学会制定,遵循德国科学医学协会联合会和推荐评估、制定和评估过程的方法指导。一个严格透明的过程包括在 13 项专门委托的系统评价中综合相关研究,评估证据的质量和强度,制定具体建议,并进行涉及领先专家和广泛利益相关者的结构化共识过程。
结果
预防和治疗种植体周围疾病的 S3 级临床实践指南最终建议在种植体放置/加载之前、期间和之后实施各种不同的干预措施。种植体周围疾病的预防应在计划、手术放置和修复加载种植体时开始。一旦植入物加载并正常工作,应构建支持性种植体护理计划,包括定期评估种植体周围组织的健康状况。如果发现种植体周围黏膜炎或种植体周围炎,必须进行适当的管理治疗。
结论
本 S3 级临床实践指南根据当时发表的证据,为临床实践、卫生系统、决策者以及间接地为公众提供了维护健康的种植体周围组织的可用的最有效方法,并提供了管理种植体周围疾病的方法。