Treatment of stage I-III periodontitis-The EFP S3 level clinical practice guideline.
The European Federation of Periodontology developed an evidence-based S3 Level Clinical Practice Guideline for treating Stage I–III periodontitis, recommending a stepwise, stage-specific approach involving behavioral modifications, biofilm management, various surgical interventions, and supportive care, to optimize long-term periodontal health.
BackgroundThe recently introduced 2017 World Workshop on the classification of periodontitis, incorporating stages and grades of disease, aims to link disease classification with approaches to prevention and treatment, as it describes not only disease severity and extent but also the degree of complexity and an individual's risk. There is, therefore, a need for evidence‐based clinical guidelines providing recommendations to treat periodontitis.AimThe objective of the current project was to develop a S3 Level Clinical Practice Guideline (CPG) for the treatment of Stage I–III periodontitis.Material and MethodsThis S3 CPG was developed under the auspices of the European Federation of Periodontology (EFP), following the methodological guidance of the Association of Scientific Medical Societies in Germany and the Grading of Recommendations Assessment, Development and Evaluation (GRADE). The rigorous and transparent process included synthesis of relevant research in 15 specifically commissioned systematic reviews, evaluation of the quality and strength of evidence, the formulation of specific recommendations and consensus, on those recommendations, by leading experts and a broad base of stakeholders.ResultsThe S3 CPG approaches the treatment of periodontitis (stages I, II and III) using a pre‐established stepwise approach to therapy that, depending on the disease stage, should be incremental, each including different interventions. Consensus was achieved on recommendations covering different interventions, aimed at (a) behavioural changes, supragingival biofilm, gingival inflammation and risk factor control; (b) supra‐ and sub‐gingival instrumentation, with and without adjunctive therapies; (c) different types of periodontal surgical interventions; and (d) the necessary supportive periodontal care to extend benefits over time.ConclusionThis S3 guideline informs clinical practice, health systems, policymakers and, indirectly, the public on the available and most effective modalities to treat periodontitis and to maintain a healthy dentition for a lifetime, according to the available evidence at the time of publication.
- # European Federation Of Periodontology
- # Grading Of Recommendations Assessment
- # Grading Of Recommendations Assessment, Development And Evaluation
- # Classification Of Periodontitis
- # Societies In Germany
- # Sub-gingival Instrumentation
- # Supragingival Biofilm
- # Grades Of Disease
- # Risk Factor Control
- # Degree Of Complexity
- Research Article
5
- 10.3760/cma.j.cn112144-20220719-00394
- Dec 9, 2022
- Zhonghua kou qiang yi xue za zhi = Zhonghua kouqiang yixue zazhi = Chinese journal of stomatology
2018 international classification of periodontal and implant diseases relates the classifications with the approaches of prevention and treatment based on the stages and grades of disease. European Federation of Periodontology (EFP) evaluated the available evidences following the methodological guidance of the Association of Scientific Medical Societies in Germany and the Grading of Recommendations Assessment, Development and Evaluation (GRADE), and published the EFP S3 level clinical practice guideline for the treatment of stage Ⅰ-Ⅲ and Ⅳ periodontitis in 2020 and 2022, respectively. The present manuscript gives introduction and interpretation based on the EFP S3 level clinical practice guideline and Chinese national conditions. On the base of the diagnostic key points of staging and grading, it introduces in detail the step treatment procedures of stageⅠ-Ⅲ periodontitis as well as the multi-disciplinary treatment procedures of stage Ⅳ periodontitis, compares the similarities and differences between the step and phase procedures, and then proposes a strategy for determining the recall interval more suitable for Chinese clinicians. The present manuscript aims to help dentists to learn and grasp the key points more quickly and accurately on the clinical application of the guideline and to assist them in making the optimal treatment plans after judging and evaluating the specific clinical circumstances, so as to maximize the chances of favorable outcome.
- Research Article
335
- 10.1111/jcpe.13639
- Jun 1, 2022
- Journal of clinical periodontology
The recently published clinical practice guideline (CPG) for the treatment of periodontitis in stages I-III provided evidence-based recommendations for the treatment of periodontitis patients, defined according to the 2018 classification. Stage IV periodontitis shares the severity and complexity characteristics of stage III periodontitis, but includes the anatomical and functional sequelae of tooth and periodontal attachment loss (tooth flaring and drifting, bite collapse, etc.), which require additional interventions following completion of active periodontal therapy. To develop an S3 Level CPG for the treatment of stage IV periodontitis, focusing on the implementation of inter-disciplinary treatment approaches required to treat/rehabilitate patients following associated sequelae and tooth loss. This S3 Level CPG was developed by the European Federation of Periodontology (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 13 specifically commissioned systematic reviews, evaluation of the quality and strength of evidence, the formulation of specific recommendations and a structured consensus process with leading experts and a broad base of stakeholders. The S3 Level CPG for the treatment of stage IV periodontitis culminated in recommendations for different interventions, including orthodontic tooth movement, tooth splinting, occlusal adjustment, tooth- or implant-supported fixed or removable dental prostheses and supportive periodontal care. Prior to treatment planning, it is critically important to undertake a definitive and comprehensive diagnosis and case evaluation, obtain relevant patient information, and engage in frequent re-evaluations during and after treatment. The periodontal component of therapy should follow the CPG for the treatment of periodontitis in stages I-III. The present S3 Level CPG informs clinical practice, health systems, policymakers and, indirectly, the public on the available and most effective modalities to treat patients with stage IV periodontitis and to maintain a healthy dentition over lifetime, according to the available evidence at the time of publication.
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312
- 10.1053/j.gastro.2020.03.072
- Apr 1, 2020
- Gastroenterology
AGA Rapid Recommendations for Gastrointestinal Procedures During the COVID-19 Pandemic
- Front Matter
195
- 10.1176/appi.ajp.2015.1720501
- Aug 1, 2015
- American Journal of Psychiatry
These Practice Guidelines for the Psychiatric Evaluation of Adults mark a transition in the American Psychiatric Association’s Practice Guidelines. Since the publication of the 2011 Institute of Medicine report Clinical Practice Guidelines We Can Trust, there has been an increasing focus on using clearly defined, transparent processes for rating the quality of evidence and the strength of the overall body of evidence in systematic reviews of the scientific literature. These guidelines were developed using a process intended to be consistent with the recommendations of the Institute of Medicine (2011), the Principles for theDevelopment of Specialty Society Clinical Guidelines of the Council of Medical Specialty Societies (2012), and the requirements of the Agency for Healthcare Research andQuality (AHRQ) for inclusion of a guideline in the National Guideline Clearinghouse. Parameters used for the guidelines’ systematic review are included with the full text of the guidelines; the development process is fully described in a document available on the APA website: http:// www.psychiatry.org/File%20Library/Practice/APA-GuidelineDevelopment-Process–updated-2011-.pdf. To supplement the expertise of members of the guideline work group, we used a “snowball” survey methodology to identify experts on psychiatric evaluation and solicit their input on aspects of the psychiatric evaluation that they saw as likely to improve specific patient outcomes (Yager 2014). Results of this expert survey are included with the full text of the practice guideline.
- Front Matter
230
- 10.1176/appi.ajp.23180001
- Feb 1, 2023
- American Journal of Psychiatry
The American Psychiatric Association Practice Guideline for the Treatment of Patients With Eating Disorders.
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2
- 10.1016/j.jclinepi.2025.112047
- Jan 1, 2026
- Journal of clinical epidemiology
Core GRADE unpacked: a summary of recent innovations in complementary GRADE methodology.
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36
- 10.1176/appi.focus.15107
- Jan 1, 2017
- Focus
(Reprinted with permission from American Journal of Psychiatry 2016; 173:543-546).
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7
- 10.1053/j.gastro.2022.03.023
- Mar 23, 2022
- Gastroenterology
AGA Institute Quality Measure Development for the Management of Gastric Intestinal Metaplasia With Helicobacter pylori
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34
- 10.46292/sci2702-152
- Jan 1, 2021
- Topics in Spinal Cord Injury Rehabilitation
Management of Mental Health Disorders, Substance Use Disorders, and Suicide in Adults with Spinal Cord Injury: Clinical Practice Guideline for Healthcare Providers.
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51
- 10.1161/cir.0000000000000891
- Oct 20, 2020
- Circulation
Evidence Evaluation Process and Management of Potential Conflicts of Interest: 2020 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations.
- Research Article
- 10.1371/journal.pone.0300841
- Mar 22, 2024
- PLOS ONE
To compared the presentation of research priorities in the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) clinical practice guidelines (CPGs) developed under the guidance of the GRADE working group or its two co-chair, and the Chinese CPGs. This was a methodological empirical analysis. We searched PubMed, Embase, and four Chinese databases (Wanfang, VIP Database for Chinese Technical Periodicals, China National Knowledge Infrastructure and Chinese Biomedical Literature Database) and retrieved nine Chinese guideline databases or Society websites as well as GRADE Pro websites. We included all eligible GRADE CPGs and a random sample of double number of Chinese CPGs, published 2018 to 2022. The reviewers independently screened and extracted the data, and we summarized and analyzed the reporting on the research priorities in the CPGs. Of the 135 eligible CPGs (45 GRADE CPGs and 90 Chinese CPGs), 668, 138 research priorities were identified respectively. More than 70% of the research priorities in GRADE CPGs and Chinese CPGs had population and intervention (PI) structure. 99 (14.8%) of GRADE CPG research priorities had PIC structures, compared with only 4(2.9%) in Chinese. And 28.4% (190) GRADE CPG research priorities reflected comparisons between PICO elements, approximately double those in Chinese. The types of research priorities among GRADE CPGs and Chinese CPGs were mostly focused on the efficacy of interventions, and the type of comparative effectiveness in the GRADE research priorities was double those in Chinese. There was still considerable room for improvement in the developing and reporting of research priorities in Chinese CPGs. Key PICO elements were inadequately presented, with more attention on intervention efficacy and insufficient consideration given to values, preferences, health equity, and feasibility. Identifying and reporting of research priorities deserves greater effort in the future.
- Research Article
16
- 10.1016/j.jdsr.2013.05.002
- Jul 15, 2013
- Japanese Dental Science Review
Primary treatment of temporomandibular disorders: The Japanese Society for the temporomandibular joint evidence-based clinical practice guidelines, 2nd edition
- Front Matter
1511
- 10.1016/j.jvs.2011.01.079
- Apr 30, 2011
- Journal of Vascular Surgery
The care of patients with varicose veins and associated chronic venous diseases: Clinical practice guidelines of the Society for Vascular Surgery and the American Venous Forum
- Research Article
- 10.1136/bmjopen-2025-105534
- Nov 1, 2025
- BMJ Open
IntroductionMany clinical practice guidelines (CPGs) claim to use Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach, but its implementation varies. This suggests that CPG developers, methodologists and users would benefit from an instrument to evaluate the extent to which CPGs adhere to GRADE approach. Such a structured instrument is currently unavailable. Accordingly, this study will develop an evaluation instrument for assessing guideline adherence to the GRADE approach, which we have named ‘GRADE-Check’. The goal is to target items to which CPGs fail to adhere and that potentially have serious consequences resulting in inaccuracies in certainty of evidence and inappropriate direction or strength of recommendations, thereby discriminating across CPGs in issues of importance.Methods and analysisThe panel will include up to 25 individuals with specific knowledge and expertise, including experienced authors, educators and methodologists on CPGs methodology and GRADE approach from relevant organisations. The instrument will focus on the key elements of GRADE, aiming for clarity for GRADE experts and non-GRADE experts to apply. The development process for GRADE-Check will consist of the following five phases: (1) recruitment of a panel of GRADE experts; (2) development of objectives and scope for the development of GRADE-Check and criteria for item selection; (3) generation of candidate items through a literature review and panel consultation; (4) panellist discussion to construct the initial draft and extended explanation manual and (5) user testing.Ethics and disseminationThis study has been approved by the Medical Ethics Committee of Zhongnan Hospital of Wuhan University (no. (2025047K)). Our research findings will be published in peer-reviewed journal articles and presented at academic conferences. Additionally, the dissemination plan will include considerations for the development of implementation manuals, a dedicated project website and training tools.
- Research Article
125
- 10.1002/ijgo.13334
- Sep 1, 2020
- International Journal of Gynecology & Obstetrics
Obstetricians and gynecologists are well positioned to influence population health through maternity and women's health services. Obesity is common in women of reproductive age and the prevalence is rising in both low-/middle-income and high-income countries 1 . Obesity affects requirements for assessment, monitoring, and intervention and can impact maternal and child outcomes. Obstetricians and gynecologists require guidance on the care of women of reproductive age with obesity at all time points related to pregnancy, including how to address modifiable risk factors such as diet and physical activity. Many guidelines have been developed to date, although they vary in scope, methodology, and individual recommendations. FIGO's Committee Guideline for the Management of Prepregnancy, Pregnancy, and Postpartum Obesity (Table It serves as a practical resource to support obstetricians and gynecologists in the management of