Clinical practice guideline for treatment of stage IV periodontitis

Perio Workshop 2021, originally due to be held in November 2020 but twice postponed because of the Covid-19 pandemic, took place in La Granja de San Ildefonso, near Segovia in Spain on November 7-9, 2021.

It involved around 80 experts from 20 countries who met to draw up a clinical practice guideline for the treatment of stage IV periodontitis. Participants included experts from other branches of dentistry, such as orthodontics and prosthodontics, and stakeholders representing relevant European institutions. 

They considered 13 systematic reviews related to treatment for stage IV periodontitis. All the reviews have been accepted for publication in the EFP’s Journal of Clinical Periodontology (JCP).

Participants were divided in four working groups: 

•   Working group 1, chaired by Søren Jepsen and Mariano Sanz, focused on orthodontic treatments.
•   Working group 2, chaired by Moritz Kebschull and Anton Sculean, dealt with patients with partial edentulism, amenable to partial rehabilitation.
•   Working group 3, chaired by Tord Berglund and Maurizio Tonetti, with the additional help of Panos Papapanou, discussed options for patients with a “terminal dentition”, only amenable to full-arch rehabilitation.
•   Working group 4, chaired by Iain Chapple and David Herrera, explored the impact of treatment of stage IV periodontitis in terms of benefits in systemic health and quality of life, together with the supportive care for successful long-term results.

The aim of the workshop was to develop an S3-level clinical practice guideline. The new guideline will complement 'The treatment of stage I-III periodontitis – the EFP S3-level clinical practice guideline, which was drawn up by Perio Workshop 2019. The S3 level of clinical practice guidelines is the highest level and requires a rigorous process in terms of both methodology and procedure. 

Following the workshop, the final documents for the guideline was prepared and the new clinical practice guideline and systematic reviews were published in a special issue of the JCP in spring 2022. The guideline was then adopted or adapted by the EFP-affiliated national societies of periodontology, and other national societies from all over the world, as happened with the EFP clinical practice guideline for the treatment of periodontitis in stages I-III.

Listen to the Perio Talks podcast on this guideline, featured by David Herrera and Moritz Kebschull.

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