背景:最近发布的治疗I-IV期牙周炎的临床实践指南(CPGs)为治疗牙周炎患者提供了循证建议,根据2018年分类定义。在2018年的分类中,种植体周围疾病也被重新定义。众所周知,种植体周围粘膜炎和种植体周围炎都非常普遍。此外,种植体周围炎的治疗尤其具有挑战性,并伴有显著的发病率.
目的:开发用于预防和治疗种植体周围疾病的S3级CPG,专注于实施预防种植体周围疾病发展或复发所需的跨学科方法,并在种植体周围疾病发展后治疗/康复种植牙的患者。
方法:该S3级CPG是由欧洲牙周病联合会开发的,遵循德国科学医学会协会的方法指导和建议评估分级,开发和评估过程。严格和透明的过程包括在13个特别委托的系统综述中对相关研究进行综合,评估证据的质量和强度,制定具体建议,以及涉及主要专家和广泛利益相关者的结构化共识过程。
结果:用于预防和治疗种植体周围疾病的S3级CPG最终建议在实施各种不同的干预措施之前,在植入物放置/装载期间和之后。种植体周围疾病的预防应在计划种植牙齿时开始,手术放置和假体装载。一旦植入物被加载并发挥作用,一个支持性的种植体周围护理计划应该是结构化的,包括植入物周围组织健康的定期评估。如果发现种植体周围粘膜炎或种植体周围炎,必须为他们的管理提供适当的治疗。
结论:目前的S3水平CPG为临床实践提供了信息,卫生系统,政策制定者和,间接地,公众了解维持健康种植体周围组织的可用和最有效的方式,为了治疗种植体周围的疾病,根据发布时的现有证据。
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.
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.
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.
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.
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.