SciELO - Scientific Electronic Library Online

 
vol.15 númeroSPCAdopción/adaptación, mediante comentario, para la federación iberopanamericana de periodoncia (FIPP) de la guía de práctica clínica (GPC) de nivel s3 de la federación europea de periodoncia (EFP), traducida por la sociedad española de periodoncia (SEPA). tratamiento de la periodontitis en estadios I-IIIDescripción del Proceso de Adopción/Adaptación, Mediante Comentario, por La Federación Iberopanamericana de Periodoncia (FIPP). índice de autoresíndice de materiabúsqueda de artículos
Home Pagelista alfabética de revistas  

Servicios Personalizados

Revista

Articulo

Indicadores

Links relacionados

  • En proceso de indezaciónCitado por Google
  • No hay articulos similaresSimilares en SciELO
  • En proceso de indezaciónSimilares en Google

Compartir


International journal of interdisciplinary dentistry

versión impresa ISSN 2452-5596versión On-line ISSN 2452-5588

Int. j interdiscip. dent. vol.15 no.spc Santiago  2022

 

Guía

Traducción al español de la Guía de Práctica Clínica de Nivel S3 de la Federación Europea de Periodoncia (EFP) - Tratamiento de la periodontitis en Estadios I-III

Mariano Sanz1 

Paula Matesanz1  2 

Juan Blanco3 

Antonio Bujaldón2 

Elena Figuero1 

Ana Molina1 

José Nart2  4 

David Herrera1 

1. Grupo de Investigación ETEP (Etiología y Terapéutica de las Enfermedades Periodontales y Periimplantarias), Universidad Complutense de Madrid, España.

2. Sociedad Española de Periodoncia, Madrid, España

3. Universidad de Santiago de Compostela, Santiago de Compostela, España

4. Universitat Internacional de Catalunya, Barcelona, España

Resumen.

Antecedentes:

La clasificación de la periodontitis recientemente introducida en el World Workshop de 2017, que incorpora estadios y grados de la enfermedad, tiene por objeto vincular la clasificación de la enfermedad con los enfoques preventivos y terapéuticos, ya que no solo describe su gravedad y el alcance, sino también el grado de complejidad y el riesgo de un individuo. Por lo tanto, es necesario contar con directrices clínicas basadas en la evidencia que ofrezcan recomendaciones para tratar la periodontitis.

Objetivo:

El objetivo del presente proyecto fue desarrollar una Guía de Práctica Clínica (CPG, por sus siglas en inglés, clinical practice guideline) de nivel S3 para el tratamiento de la periodontitis en los estadios I-III.

Material y métodos:

Estas CPG S3 se elaboraron bajo los auspicios de la Federación Europea de Periodoncia (EFP), siguiendo la orientación metodológica de la Asociación de Sociedades Médico-Científicas de Alemania y la estructura Grading of Recommendations Assessment, Development and Evaluation (GRADE). El proceso, riguroso y transparente, incluyó la síntesis de las investigaciones relevantes en 15 revisiones sistemáticas encargadas de manera específica, la evaluación de la calidad y la solidez de la evidencia, la formulación de recomendaciones específicas, así como lograr un acuerdo, sobre esas recomendaciones, por parte de expertos destacados y una amplia base de partes interesadas.

Resultados:

Estas CPG S3 abordan el tratamiento de la periodontitis (estadios I, II y III) utilizando un enfoque gradual preestablecido del tratamiento que, según el estadio de la enfermedad, debe ser incremental, incluyendo en cada caso diferentes intervenciones. Se llegó a un acuerdo sobre las recomendaciones relativas a las diferentes intervenciones, dirigidas a: i) cambios de comportamiento, control de biofilm supragingival, inflamación gingival y factores de riesgo; ii) instrumentación supragingival y subgingival, con y sin tratamientos coadyuvantes; iii) diferentes tipos de intervenciones quirúrgicas periodontales; y iv) el mantenimiento periodontal necesario para extender los beneficios a lo largo del tiempo.

Conclusión:

Esta Guía S3 informa a los clínicos, a los sistemas de salud, a los encargados de formular políticas sanitarias e, indirectamente, al público, sobre las modalidades disponibles y más eficaces para tratar la periodontitis y mantener una dentición sana durante toda la vida, de acuerdo con la evidencia disponible en el momento de su publicación.

Palabras clave: Periodontitis; estadio; grado; guía de práctica clínica; tratamiento periodontal; política sanitaria; salud oral.

Texto completo disponible sólo en PDF

Full text available only in PDF format

Referencias bibliográficas

Referencias bibliográficas (Tablas y Figuras)

Abouassi, T., Woelber, J., Holst, K., Stampf, S., Doerfer, C., Hellwig, E., & Ratka-Krüger, P. (2014). Clinical efficacy and patients‘ acceptance of a rubber interdental bristle. A randomized controlled trial. Clinical Oral Investigations(18), 7. doi:10.1007/s00784-013-1164-3. [ Links ]

Adam, O., & Laufs, U. (2008). Antioxidative effects of statins. Archives of Toxicology, 82(12), 885-892. doi:10.1007/s00204-008-0344-4 [ Links ]

Araujo, A.A., Pereira, A., Medeiros, C., Brito, G.A.C., Leitao, R. F. C., Araujo, L. S., Araujo Junior, R. F. (2017). Effects of metformin on inflammation, oxidative stress, and bone loss in a rat model of periodontitis. PLoS One, 12(8), e0183506. doi:10.1371/journal.pone.0183506 [ Links ]

Badran, Z., Kraehenmann, M. A., Guicheux, J., & Soueidan, A. (2009). Bisphosphonates in periodontal treatment: a review. Oral Health and Preventive Dentistry, 7(1), 3-12. [ Links ]

Balshem, H., Helfand, M., Schunemann, H. J., Oxman, A. D., Kunz, R., Brozek, J., Guyatt, G. H. (2011). GRADE guidelines: 3. Rating the quality of evidence. Journal of Clinical Epidemiology, 64(4), 401-406. doi:10.1016/j.jclinepi.2010.07.015 [ Links ]

Bescos, R., Ashworth, A., Cutler, C., Brookes, Z. L., Belfield, L., Rodiles, A., Hickson, M. (2020). Effects of Chlorhexidine mouthwash on the oral microbiome. Science Reports, 10(1), 5254. doi:10.1038/s41598-020-61912-4 [ Links ]

Billings, M., Holtfreter, B., Papapanou, P. N., Mitnik, G. L., Kocher, T., & Dye, B. A. (2018). Age-dependent distribution of periodontitis in two countries: Findings from NHANES 2009 to 2014 and SHIP-TREND 2008 to 2012. Journal of Clinical Periodontology, 45 Suppl 20, S130-S148. doi:10.1111/jcpe.12944 [ Links ]

Broadbent, J. M., Williams, K. B., Thomson, W. M., & Williams, S. M. (2006). Dental restorations: a risk factor for periodontal attachment loss? Journal of Clinical Periodontology , 33, 803-810. doi:10.1111/j.1600-051X.2006.00988.x [ Links ]

Brocklehurst, P. R., McKenna, G., Schimmel, M., Kossioni, A., Jerkovic-Cosic, K., Hayes, M., Muller, F. (2018). How do we incorporate patient views into the design of healthcare services for older people: a discussion paper. BMC Oral Health, 18(1), 61. doi:10.1186/s12903-018-0513-7 [ Links ]

Carra, M. C., Detzen, L., Kitzmann, J., Woelber, J. P., Ramseier, C. A., & Bouchard, P. (2020). Promoting behavioural changes to improve oral hygiene in patients with periodontal diseases: a systematic review. Journal of Clinical Periodontology . doi:10.1111/jcpe.13234 [ Links ]

Carvalho, V. F., Andrade, P. V., Rodrigues, M. F., Hirata, M. H., Hirata, R. D., Pannuti, C. M., Conde, M. C. (2015). Antimicrobial photodynamic effect to treat residual pockets in periodontal patients: a randomized controlled clinical trial. Journal of Clinical Periodontology , 42(5), 440-447. doi:10.1111/jcpe.12393 [ Links ]

Caton, J. G., Armitage, G., Berglundh, T., Chapple, I. L. C., Jepsen, S., K.S., K., M.S., T. (2018). A new classification scheme for periodontal and peri-implant diseases and conditions - Introduction and key changes from the 1999 classification. Journal of Clinical Periodontology , 45 (Suppl 20), S1-S8. doi:10.1111/jcpe.12935 [ Links ]

Caton, J. G., Ciancio, S. G., Blieden, T. M., Bradshaw, M., Crout, R. J., Hefti, A. F., Walker, C. (2000). Treatment with subantimicrobial dose doxycycline improves the efficacy of scaling and root planing in patients with adult periodontitis. Journal of Periodontology, 71(4), 521-532. doi:10.1902/jop.2000.71.4.521 [ Links ]

Caton, J. G., Ciancio, S. G., Blieden, T. M., Bradshaw, M., Crout, R. J., Hefti, A. F., Walker, C. (2001). Subantimicrobial dose doxycycline as an adjunct to scaling and root planing: post-treatment effects. Journal of Clinical Periodontology , 28(8), 782-789. doi:10.1034/j.1600-051x.2001.280810.x [ Links ]

Chapple, I. L. C., Mealey, B. L., Van Dyke, T. E., Bartold, P. M., Dommisch, H., Eickholz, P., Yoshie, H. (2018). Periodontal health and gingival diseases and conditions on an intact and a reduced periodontium: Consensus report of workgroup 1 of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions. Journal of Clinical Periodontology , 45 (Suppl 20), S68-S77. doi:10.1111/jcpe.12940 [ Links ]

Chapple, I. L. C., Van der Weijden, F., Doerfer, C., Herrera, D., Shapira, L., Polak, D., Graziani, F. (2015). Primary prevention of periodontitis: managing gingivitis. Journal of Clinical Periodontology , 42 Suppl 16, S71-76. doi:10.1111/jcpe.12366 [ Links ]

Cicek Ari, V., Ilarslan, Y. D., Erman, B., Sarkarati, B., Tezcan, I., Karabulut, E., Berker, E. (2016). Statins and IL-1beta, IL-10, and MPO Levels in Gingival Crevicular Fluid: Preliminary Results. Inflammation, 39(4), 1547-1557. doi:10.1007/s10753-016-0390-7 [ Links ]

Cortellini, P., Buti, J., Pini Prato, G., & Tonetti, M. S. (2017). Periodontal regeneration compared with access flap surgery in human intra-bony defects 20-year follow-up of a randomized clinical trial: tooth retention, periodontitis recurrence and costs. Journal of Clinical Periodontology , 44(1), 58-66. doi:10.1111/jcpe.12638 [ Links ]

Cortellini, P., Prato, G. P., & Tonetti, M. S. (1995). The modified papilla preservation technique. A new surgical approach for interproximal regenerative procedures. Journal of Periodontology , 66(4), 261-266. doi:10.1902/jop.1995.66.4.261 [ Links ]

Cortellini, P., Prato, G. P., & Tonetti, M. S. (1999). The simplified papilla preservation flap. A novel surgical approach for the management of soft tissues in regenerative procedures. International Journal of Periodontics and Restorative Dentistry, 19(6), 589-599. [ Links ]

Cortellini, P., & Tonetti, M. S. (2007). A minimally invasive surgical technique with an enamel matrix derivative in the regenerative treatment of intra-bony defects: a novel approach to limit morbidity. Journal of Clinical Periodontology , 34(1), 87-93. doi:10.1111/j.1600-051X.2006.01020.x [ Links ]

Cortellini, P., & Tonetti, M. S. (2009). Improved wound stability with a modified minimally invasive surgical technique in the regenerative treatment of isolated interdental intrabony defects. Journal of Clinical Periodontology , 36(2), 157-163. doi:10.1111/j.1600-051X.2008.01352.x [ Links ]

Costa, F. O., Lages, E. J., Cota, L. O., Lorentz, T. C., Soares, R. V., & Cortelli, J. R. (2014). Tooth loss in individuals under periodontal maintenance therapy: 5-year prospective study. Journal of Periodontal Research, 49(1), 121-128. doi:10.1111/jre.12087 [ Links ]

Cummins, D., & Creeth, J. E. (1992). Delivery of antiplaque agents from dentifrices, gels, and mouthwashes. Journal of Dental Research, 71(7), 1439-1449. doi:10.1177/00220345920710071601 [ Links ]

da Costa, L. F. N. P., Amaral, C. D. S. F., Barbirato, D. D. S., Leao, A. T. T., & Fogacci, M. F. (2017). Chlorhexidine mouthwash as an adjunct to mechanical therapy in chronic periodontitis: A meta-analysis. Journal of the American Dental Association, 148(5), 308-318. doi:10.1016/j.adaj.2017.01.021 [ Links ]

de Santana, R. B., Gusman, H. C., & Van Dyke, T. E. (1999). The response of human buccal maxillary furcation defects to combined regenerative techniques--two controlled clinical studies. Journal of the International Academy of Periodontology, 1(3), 69-77. [ Links ]

Dommisch, H., Walter, C., Dannewitz, B., & Eickholz, P. (2020). Resective surgery for the treatment of furcation involvement - a systematic review. Journal of Clinical Periodontology . doi:10.1111/jcpe.13241 [ Links ]

Donos, N., Calciolari, E., Brusselaers, N., Goldoni, M., Bostanci, N., & Belibasakis, G. N. (2019). The adjunctive use of host modulators in non-surgical periodontal therapy. A systematic review of randomized, placebo-controlled clinical studies. Journal of Clinical Periodontology . doi:10.1111/jcpe.13232 [ Links ]

Eberhard, J., Jepsen, S., Jervoe-Storm, P. M., Needleman, I., & Worthington, H. V. (2015). Full-mouth treatment modalities (within 24 hours) for chronic periodontitis in adults. Cochrane Database of Systematic Reviews(4), CD004622. doi:10.1002/14651858.CD004622.pub3 [ Links ]

Escribano, M., Figuero, E., Martin, C., Tobias, A., Serrano, J., Roldan, S., & Herrera, D. (2016). Efficacy of adjunctive anti-plaque chemical agents: a systematic review and network meta-analyses of the Turesky modification of the Quigley and Hein plaque index. Journal of Clinical Periodontology , 43(12), 1059-1073. doi:10.1111/jcpe.12616 [ Links ]

Fardal, O., & Grytten, J. (2014). Applying quality assurance in real time to compliant long-term periodontal maintenance patients utilizing cost-effectiveness and cost utility. Journal of Clinical Periodontology , 41(6), 604-611. doi:10.1111/jcpe.12252 [ Links ]

Figuero, E., Herrera, D., Tobias, A., Serrano, J., Roldan, S., Escribano, M., & Martin, C. (2019). Efficacy of adjunctive anti-plaque chemical agents in managing gingivitis: A systematic review and network meta-analyses. Journal of Clinical Periodontology , 46(7), 723-739. doi:10.1111/jcpe.13127 [ Links ]

Figuero, E., Roldan, S., Serrano, J., Escribano, M., Martin, C., & Preshaw, P. M. (2019). Efficacy of adjunctive therapies in patients with gingival inflammation. A systematic review and meta-analysis. Journal of Clinical Periodontology . doi:10.1111/jcpe.13244 [ Links ]

Gandhi, K. K., Pavaskar, R., Cappetta, E. G., & Drew, H. J. (2019). Effectiveness of Adjunctive Use of Low-Level Laser Therapy and Photodynamic Therapy After Scaling and Root Planing in Patients with Chronic Periodontitis. Int J Periodontics Restorative Dent, 39(6), 837-843. doi:10.11607/prd.4252 [ Links ]

Garrett, S., Polson, A. M., Stoller, N. H., Drisko, C. L., Caton, J. G., Harrold, C. Q., DeRouen, T. A. (1997). Comparison of a bioabsorbable GTR barrier to a non-absorbable barrier in treating human class II furcation defects. A multi-center parallel design randomized single-blind trial. Journal of Periodontology , 68(7), 667-675. doi:10.1902/jop.1997.68.7.667 [ Links ]

Gatej, S., Gully, N., Gibson, R., & Bartold, P. M. (2017). Probiotics and Periodontitis - A Literature Review. Journal of the International Academy of Periodontology , 19(2), 42-50. [ Links ]

GBD 2017 Disease and Injury Incidence and Prevalence Collaborators. (2018). Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet, 392(10159), 1789-1858. doi:10.1016/s0140-6736(18)32279-7 [ Links ]

German Association of the Scientific Medical Societies (AWMF), & Standing Guidelines Commission. (2012). AWMF Guidance Manual and Rules for Guideline Development. Retrieved from (accessed on 03.13.2020) website: 2020) website: http://www.awmf.org/leitlinien/awmf-regelwerk.htmlLinks ]

Gomes, S. C., Romagna, R., Rossi, V., Corvello, P. C., & Angst, P. D. (2014). Supragingival treatment as an aid to reduce subgingival needs: a 450-day investigation. Brazilian Oral Research, 28. doi:10.1590/S1806-83242014.50000004 [ Links ]

Graziani, F., Gennai, S., Cei, S., Cairo, F., Baggiani, A., Miccoli, M., Tonetti, M. (2012). Clinical performance of access flap surgery in the treatment of the intrabony defect. A systematic review and meta-analysis of randomized clinical trials. Journal of Clinical Periodontology , 39(2), 145-156. doi:10.1111/j.1600-051X.2011.01815.x [ Links ]

Graziani, F., Gennai, S., Karapetsa, D., Rosini, S., Filice, N., Gabriele, M., & Tonetti, M. (2015). Clinical performance of access flap in the treatment of class II furcation defects. A systematic review and meta-analysis of randomized clinical trials. Journal of Clinical Periodontology , 42(2), 169-181. doi:10.1111/jcpe.12327 [ Links ]

Guyatt, G. H., Oxman, A. D., Kunz, R., Atkins, D., Brozek, J., Vist, G., Schunemann, H. J. (2011). GRADE guidelines: 2. Framing the question and deciding on important outcomes. Journal of Clinical Epidemiology , 64(4), 395-400. doi:10.1016/j.jclinepi.2010.09.012 [ Links ]

Harrel, S. K. (1999). A minimally invasive surgical approach for periodontal regeneration: surgical technique and observations. Journal of Periodontology , 70(12), 1547-1557. doi:10.1902/jop.1999.70.12.1547 [ Links ]

Heasman, P. A., McCracken, G. I., & Steen, N. (2002). Supportive periodontal care: the effect of periodic subgingival debridement compared with supragingival prophylaxis with respect to clinical outcomes. Journal of Clinical Periodontology , 29(Suppl 3), 163-172. doi:10.1034/j.1600-051x.29.s3.9.x [ Links ]

Hennequin-Hoenderdos, N. L., van der Sluijs, E., van der Weijden, G. A., & Slot, D. E. (2018). Efficacy of a rubber bristles interdental cleaner compared to an interdental brush on dental plaque, gingival bleeding and gingival abrasion: A randomized clinical trial. International Journal of Dental Hygiene, 16(3), 380-388. doi:10.1111/idh.12316. [ Links ]

Herrera, D., Matesanz, P., Martin, C., Oud, V., Feres, M., & Teughels, W. (2020). Adjunctive effect of locally delivered antimicrobials in periodontitis therapy. A systematic review and meta-analysis. Journal of Clinical Periodontology . doi:10.1111/jcpe.13230 [ Links ]

Herrera, D., Retamal-Valdes, B., Alonso, B., & Feres, M. (2018). Acute periodontal lesions (periodontal abscesses and necrotizing periodontal diseases) and endo-periodontal lesions. Journal of Clinical Periodontology , 45 Suppl 20, S78-S94. doi:10.1111/jcpe.12941 [ Links ]

Hill, G., Dehn, C., Hinze, A. V., Frentzen, M., & Meister, J. (2019). Indocyanine green-based adjunctive antimicrobial photodynamic therapy for treating chronic periodontitis: A randomized clinical trial. Photodiagnosis Photodyn Ther, 26, 29-35. doi:10.1016/j.pdpdt.2019.02.019 [ Links ]

Hugoson, A., Ravald, N., Fornell, J., Johard, G., Teiwik, A., & Gottlow, J. (1995). Treatment of class II furcation involvements in humans with bioresorbable and nonresorbable guided tissue regeneration barriers. A randomized multi-center study. Journal of Periodontology , 66(7), 624-634. doi:10.1902/jop.1995.66.7.624 [ Links ]

Huynh-Ba, G., Kuonen, P., Hofer, D., Schmid, J., Lang, N. P., & Salvi, G. E. (2009). The effect of periodontal therapy on the survival rate and incidence of complications of multirooted teeth with furcation involvement after an observation period of at least 5 years: a systematic review. Journal of Clinical Periodontology , 36(2), 164-176. doi:10.1111/j.1600-051X.2008.01358.x [ Links ]

International Committee of Medical Editors. ICMJE Form for Disclosure of Potential Conflicts of Interest. Retrieved from http://www.icmje.org/conflicts-of-interest/Links ]

IQWiG. (2016). Präferenzmessung bei Parodontopathien. Institut für Qualität und Wirtschaftlichkeit im Gesundheitswesen, 466. [ Links ]

Jepsen, S., Caton, J. G., Albandar, J. M., Bissada, N. F., Bouchard, P., Cortellini, P., Yamazaki, K. (2018). Periodontal manifestations of systemic diseases and developmental and acquired conditions: Consensus report of workgroup 3 of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions. Journal of Clinical Periodontology , 45(Suppl 20), S219-S229. doi: 10.1111/jcpe.12951 [ Links ]

Jepsen, S., Eberhard, J., Herrera, D., & Needleman, I. (2002). A systematic review of guided tissue regeneration for periodontal furcation defects. What is the effect of guided tissue regeneration compared with surgical debridement in the treatment of furcation defects? Journal of Clinical Periodontology , 29 Suppl 3, 103-116; discussion 160-102. doi:10.1034/j.1600-051x.29.s3.6.x [ Links ]

Jepsen, S., Gennai, S., Hirschfeld, J., Kalemaj, Z., Buti, J., & Graziani, F. (2019). Regenerative surgical treatment of furcation defects: A systematic review and Bayesian network meta-analysis of randomized clinical trials. Journal of Clinical Periodontology . doi:10.1111/jcpe.13238 [ Links ]

Kassebaum, N. J., Bernabe, E., Dahiya, M., Bhandari, B., Murray, C. J., & Marcenes, W. (2014). Global burden of severe periodontitis in 1990-2010: a systematic review and meta-regression. Journal of Dental Research , 93(11), 1045-1053. doi:10.1177/0022034514552491 [ Links ]

Kassebaum, N. J., Smith, A. G. C., Bernabe, E., Fleming, T. D., Reynolds, A. E., Vos, T, GBD 2015 Oral Health Collaborators. (2017). Global, Regional, and National Prevalence, Incidence, and Disability-Adjusted Life Years for Oral Conditions for 195 Countries, 1990-2015: A Systematic Analysis for the Global Burden of Diseases, Injuries, and Risk Factors. Journal of Dental Research , 96(4), 380-387. doi:10.1177/0022034517693566 [ Links ]

Katsikanis, F., Strakas, D., & Vouros, I. (2019). The application of antimicrobial photodynamic therapy (aPDT, 670 nm) and diode laser (940 nm) as adjunctive approach in the conventional cause-related treatment of chronic periodontal disease: a randomized controlled split-mouth clinical trial. Clin Oral Investig. doi:10.1007/s00784-019-03045-1 [ Links ]

Kieser, J. B. (1994). Non-surgical periodontal therapy. In N. P. Lang & T. Karring (Eds.), Proceedings of the 1st European Workshop on Periodontology. Germany: Quintessence Publishing Co. [ Links ]

Killeen, A. C., Harn, J. A., Erickson, L. M., Yu, F., & Reinhardt, R. A. (2016). Local Minocycline Effect on Inflammation and Clinical Attachment During Periodontal Maintenance: Randomized Clinical Trial. Journal of Periodontology , 87(10), 1149-1157. doi:10.1902/jop.2016.150551 [ Links ]

Killeen, A. C., Harn, J. A., Jensen, J., Yu, F., Custer, S., & Reinhardt, R. A. (2018). Two-Year Randomized Clinical Trial of Adjunctive Minocycline Microspheres in Periodontal Maintenance. J Dent Hyg, 92(4), 51-58. [ Links ]

Klein, E. Y., Van Boeckel, T. P., Martinez, E. M., Pant, S., Gandra, S., Levin, S. A., Laxminarayan, R. (2018). Global increase and geographic convergence in antibiotic consumption between 2000 and 2015. Proc Natl Acad Sci U S A, 115(15), E3463-E3470. doi:10.1073/pnas.1717295115 [ Links ]

Krohn-Dale, I., Boe, O. E., Enersen, M., & Leknes, K. N. (2012). Er:YAG laser in the treatment of periodontal sites with recurring chronic inflammation: a 12-month randomized, controlled clinical trial. Journal of Clinical Periodontology , 39(8), 745-752. doi:10.1111/j.1600-051X.2012.01912.x [ Links ]

Kumar, K., Sharma, R. K., Tewari, S., & Narula, S. C. (2019). Use of modified vertical internal mattress suture versus simple loop interrupted suture in modified Widman flap surgery: a randomized clinical study. Quintessence Int, 50(9), 732-740. doi:10.3290/j.qi.a43049 [ Links ]

Lang, N. P., Kiel, R. A., & Anderhalden, K. (1983). Clinical and microbiological effects of subgingival restorations with overhanging or clinically perfect margins. Journal of Clinical Periodontology , 10(6), 563-578. [ Links ]

Loos, B. G., & Needleman, I. (2020). Endpoints of active periodontal therapy. Journal of Clinical Periodontology . doi:10.1111/jcpe.13253 [ Links ]

Mennickent, C. S., Bravo, D. M., Calvo, M. C., & Avello, L. M. (2008). [Pleiotropic effects of statins]. Revista Médica de Chile, 136(6), 775-782. doi: /S0034-98872008000600014 [ Links ]

Ministerio de Sanidad, C. y. B. S.,(2019). Plan Nacional frente a la Resistencia a los Antibióticos (PRAN) 2019-2021. Retrieved from Madrid: [ Links ]

Moher, D., Liberati, A., Tetzlaff, J., & Altman, D. G. (2009). Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Journal of Clinical Epidemiology , 62(10), 1006-1012. doi:10.1016/j.jclinepi.2009.06.005 [ Links ]

Murphy, M. K., Black, N. A., Lamping, D. L., McKee, C. M., Sanderson, C. F., Askham, J., & Marteau, T. (1998). Consensus development methods, and their use in clinical guideline development. Health Technology Assessment, 2(3), i-iv, 1-88. [ Links ]

Needleman, I., Nibali, L., & Di Iorio, A. (2015). Professional mechanical plaque removal for prevention of periodontal diseases in adults--systematic review update. Journal of Clinical Periodontology , 42 Suppl 16, S12-35. doi:10.1111/jcpe.12341 [ Links ]

Niazi, F. H., Noushad, M., Tanvir, S. B., Ali, S., Al-Khalifa, K. S., Qamar, Z., & Al-Sheikh, R. (2020). Antimicrobial efficacy of indocyanine green-mediated photodynamic therapy compared with Salvadora persica gel application in the treatment of moderate and deep pockets in periodontitis. Photodiagnosis Photodyn Ther , 29, 101665. doi:10.1016/j.pdpdt.2020.101665 [ Links ]

Nibali, L., Akcali, A., & Rudiger, S. G. (2019). The importance of supportive periodontal therapy for molars treated with furcation tunnelling. Journal of Clinical Periodontology , 46(12), 1228-1235. doi:10.1111/jcpe.13181 [ Links ]

Nibali, L., Koidou, V. P., Nieri, M., Barbato, L., Pagliaro, U., & Cairo, F. (2019). Regenerative surgery versus access flap for the treatment of intrabony periodontal defects. A systematic review and meta-analysis. Journal of Clinical Periodontology . doi:10.1111/jcpe.13237 [ Links ]

Nibali, L., Zavattini, A., Nagata, K., Di Iorio, A., Lin, G. H., Needleman, I., & Donos, N. (2016). Tooth loss in molars with and without furcation involvement - a systematic review and meta-analysis. Journal of Clinical Periodontology , 43(2), 156-166. doi:10.1111/jcpe.12497 [ Links ]

Nyman, S., Lindhe, J., & Rosling, B. (1977). Periodontal surgery in plaque-infected dentitions. Journal of Clinical Periodontology , 4(4), 240-249. doi:10.1111/j.1600-051x.1977.tb01896.x [ Links ]

O‘Leary, T. J., Drake, R. B., & Naylor, J. E. (1972). The plaque control record. Journal of Periodontology , 43(1), 38. doi:10.1902/jop.1972.43.1.38 [ Links ]

Papapanou, P. N., Sanz, M., Buduneli, N., Dietrich, T., Feres, M., Fine, D. H., Tonetti, M. S. (2018). Periodontitis: Consensus report of workgroup 2 of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions. Journal of Clinical Periodontology , 45(Suppl 20), S162-S170. doi:10.1111/jcpe.12946 [ Links ]

Pelekos G., Ho S. N., Acharya A., Leung W. K. & McGrath C. (2019). A double-blind, paralleled-arm, placebo-controlled and randomized clinical trial of the effectiveness of probiotics as an adjunct in periodontal care. Journal of Clinical Periodontology , 46(12), 1217-1227. doi:10.1111/jcpe.13191 [ Links ]

Petit, C., Batool, F., Bugueno, I. M., Schwinte, P., Benkirane-Jessel, N., & Huck, O. (2019). Contribution of Statins towards Periodontal Treatment: A Review. Mediators of Inflammation, 2019, 6367402. doi:10.1155/2019/6367402 [ Links ]

Polak, D., Wilensky, A., Antonoglou, G. N., Shapira, L., Goldstein, M., & Martin, C. (2020). The Efficacy of Pocket Elimination/Reduction Compared to Access Flap Surgery: A Systematic Review and Meta-analysis. Journal of Clinical Periodontology . doi:10.1111/jcpe.13246 [ Links ]

Proceedings of the 1996 World Workshop in Periodontics. (1996). Consensus report. Periodontal regeneration around natural teeth. Annals of Periodontology, 1(1), 667-670. doi:10.1902/annals.1996.1.1.667 [ Links ]

Ramseier, C. A., Nydegger, M., Walter, C., Fischer, G., Sculean, A., Lang, N. P., & Salvi, G. E. (2019). Time between recall visits and residual probing depths predict long-term stability in patients enrolled in supportive periodontal therapy. Journal of Clinical Periodontology , 46(2), 218-230. doi:10.1111/jcpe.13041. [ Links ]

Ramseier, C. A., Woelber, J. P., Kitzmann, J., Detzen, L., Carra, M. C., & Bouchard, P. (2020). Impact of risk factor control interventions for smoking cessation and promotion of healthy lifestyles in patients with periodontitis: a systematic review. Journal of Clinical Periodontology . doi:10.1111/jcpe.13240 [ Links ]

Reinhardt, R. A., Stoner, J. A., Golub, L. M., Wolff, M. S., Lee, H. M., Meinberg, T. A., Payne, J. B. (2007). Efficacy of sub-antimicrobial dose doxycycline in post-menopausal women: clinical outcomes. Journal of Clinical Periodontology , 34(9), 768-775. doi:10.1111/j.1600-051X.2007.01114.x [ Links ]

Righolt, A. J., Jevdjevic, M., Marcenes, W., & Listl, S. (2018). Global-, Regional-, and Country-Level Economic Impacts of Dental Diseases in 2015. Journal of Dental Research , 97(5), 501-507. doi:10.1177/0022034517750572 [ Links ]

Rosling, B., Nyman, S., Lindhe, J., & Jern, B. (1976). The healing potential of the periodontal tissues following different techniques of periodontal surgery in plaque-free dentitions. A 2-year clinical study. Journal of Clinical Periodontology , 3(4), 233-250. doi:10.1111/j.1600-051x.1976.tb00042.x [ Links ]

Rosling, B., Wannfors, B., Volpe, A. R., Furuichi, Y., Ramberg, P., & Lindhe, J. (1997). The use of a triclosan/copolymer dentifrice may retard the progression of periodontitis. Journal of Clinical Periodontology , 24(12), 873-880. doi:10.1111/j.1600-051x.1997.tb01205.x [ Links ]

Rudiger, S. G., Dahlen, G., & Emilson, C. G. (2019). The furcation tunnel preparation-A prospective 5-year follow-up study. Journal of Clinical Periodontology , 46(6), 659-668. doi:10.1111/jcpe.13120 [ Links ]

Salvi, G. E., Stahli, A., Schmidt, J. C., Ramseier, C. A., Sculean, A., & Walter, C. (2019). Adjunctive laser or antimicrobial photodynamic therapy to non-surgical mechanical instrumentation in patients with untreated periodontitis. A systematic review and meta-analysis. Journal of Clinical Periodontology . doi:10.1111/jcpe.13236 [ Links ]

Sanz, M., Baumer, A., Buduneli, N., Dommisch, H., Farina, R., Kononen, E., Winkel, E. (2015). Effect of professional mechanical plaque removal on secondary prevention of periodontitis and the complications of gingival and periodontal preventive measures: consensus report of group 4 of the 11th European Workshop on Periodontology on effective prevention of periodontal and peri-implant diseases. Journal of Clinical Periodontology , 42 Suppl 16, S214-220. doi:10.1111/jcpe.12367 [ Links ]

Sanz, M., Ceriello, A., Buysschaert, M., Chapple, I., Demmer, R. T., Graziani, F., Vegh, D. (2018). Scientific evidence on the links between periodontal diseases and diabetes: Consensus report and guidelines of the joint workshop on periodontal diseases and diabetes by the International Diabetes Federation and the European Federation of Periodontology. Journal of Clinical Periodontology , 45(2), 138-149. doi:10.1111/jcpe.12808 [ Links ]

Sanz, M., Kornman, K., & Working group 3 of joint EFP/AAP Workshop. (2013). Periodontitis and adverse pregnancy outcomes: consensus report of the Joint EFP/AAP Workshop on Periodontitis and Systemic Diseases. Journal of Clinical Periodontology , 40 Suppl 14, S164-169. doi:10.1111/jcpe.12083 [ Links ]

Sanz, M., Marco del Castillo, A., Jepsen, S., Gonzalez-Juanatey, J. R., D’Aiuto, F., Bouchard, P., Wimmer, G. (2019). Periodontitis and cardiovascular diseases: Consensus report. Journal of Clinical Periodontology , In press. [ Links ]

Sanz, M., & Meyle, J. (2010). Scope, competences, learning outcomes and methods of periodontal education within the undergraduate dental curriculum: a consensus report of the 1st European Workshop on Periodontal Education--position paper 2 and consensus view 2. European Journal of Dental Education, 14(Suppl 1), 25-33. doi:10.1111/j.1600-0579.2010.00621.x. [ Links ]

Sanz, M., van der Velden, U., van Steenberghe, D., & Baehni, P. (2006). Periodontology as a recognized dental speciality in Europe. Journal of Clinical Periodontology , 33(6), 371-375. doi:10.1111/j.1600-051X.2006.00932.x [ Links ]

Sanz-Sanchez, I., Montero, E., Citterio, F., Romano, F., Molina, A., & Aimetti, M. (2020). Efficacy of access flap procedures compared to subgingival debridement in the treatment of periodontitis. A systematic review and meta-analysis. Journal of Clinical Periodontology . doi:10.1111/jcpe.13259 [ Links ]

Schunemann, H. J., Al-Ansary, L. A., Forland, F., Kersten, S., Komulainen, J., Kopp, I. B., Board of Trustees of the Guidelines International Network. (2015). Guidelines International Network: Principles for Disclosure of Interests and Management of Conflicts in Guidelines. Annals of Internal Medicine, 163(7), 548-553. doi:10.7326/M14-1885 [ Links ]

Schunemann, H. J., Wiercioch, W., Brozek, J., Etxeandia-Ikobaltzeta, I., Mustafa, R. A., Manja, V., Akl, E. A. (2017). GRADE Evidence to Decision (EtD) frameworks for adoption, adaptation, and de novo development of trustworthy recommendations: GRADE-ADOLOPMENT. Journal of Clinical Epidemiology , 81, 101-110. doi:10.1016/j.jclinepi.2016.09.009 [ Links ]

Schwendicke, F., Graetz, C., Stolpe, M., & Dorfer, C. E. (2014). Retaining or replacing molars with furcation involvement: a cost-effectiveness comparison of different strategies. Journal of Clinical Periodontology , 41(11), 1090-1097. doi:10.1111/jcpe.12315 [ Links ]

Schwendicke, F., Plaumann, A., Stolpe, M., Dorfer, C. E., & Graetz, C. (2016). Retention costs of periodontally compromised molars in a German population. Journal of Clinical Periodontology , 43(3), 261-270. doi:10.1111/jcpe.12509 [ Links ]

Serhan, C. N. (2017). Discovery of specialized pro-resolving mediators marks the dawn of resolution physiology and pharmacology. Molecular Aspects of Medicine, 58, 1-11. doi:10.1016/j.mam.2017.03.001 [ Links ]

Serrano, J., Escribano, M., Roldan, S., Martin, C., & Herrera, D. (2015). Efficacy of adjunctive anti-plaque chemical agents in managing gingivitis: a systematic review and meta-analysis. Journal of Clinical Periodontology , 42 Suppl 16, S106-138. doi:10.1111/jcpe.12331 [ Links ]

Sezen, D., Hatipoglu, M., & Ustun, K. (2020). Evaluation of the clinical and biochemical efficacy of erbium, chromium:ytrium-scandium-gallium-garnet (ER,CR:YSGG) laser treatment in periodontitis. Lasers Med Sci. doi:10.1007/s10103-020-02990-8 [ Links ]

Shea, B. J., Reeves, B. C., Wells, G., Thuku, M., Hamel, C., Moran, J., Henry, D. A. (2017). AMSTAR 2: a critical appraisal tool for systematic reviews that include randomised or non-randomised studies of healthcare interventions, or both. British Medical Journal, 358, j4008. doi:10.1136/bmj.j4008 [ Links ]

Slot, D. E., Valkenburg, C., & van der Weijden, F. (2020). Mechanical plaque removal of periodontal maintenance patients -A systematic review and network meta-analysis. Journal of Clinical Periodontology , in press. [ Links ]

Stavropoulos, A., Bertl, K., Spineli, L., Sculean, A., Cortellini, P., & Tonetti, M. (2020). Medium- and Long-Term Clinical Benefits of Periodontal Regenerative/Reconstructive Procedures in Intrabony Defects: Systematic Review and Network Meta-Analysis of Randomized Controlled Clinical Studies. Journal of Clinical Periodontology ((accepted for publication)). [ Links ]

Steenackers, K., Vijt, J., Leroy, R., De Vree, H., & De Boever, J. A. (2001). Short-term clinical study comparing supragingival plaque removal and gingival bleeding reduction of the Philips Jordan HP735 to a manual toothbrush in periodontal patients in a maintenance program. Journal of Clinical Dentistry, 12(1), 17-20. [ Links ]

Suvan, J., Leira, Y., Moreno, F., Graziani, F., Derks, J., & Tomasi, C. (2019). Subgingival Instrumentation for Treatment of Periodontitis. A Systematic Review. Journal of Clinical Periodontology . doi:10.1111/jcpe.13245 [ Links ]

Teughels, W., Feres, M., Oud, V., Martin, C., Matesanz, P., & Herrera, D. (2020). Adjunctive effect of systemic antimicrobials in periodontitis therapy. A systematic review and meta-analysis. Journal of Clinical Periodontology . doi:10.1111/jcpe.13264 [ Links ]

Tinto, M., Sartori, M., Pizzi, I., Verga, A., & Longoni, S. (2020). Melatonin as host modulating agent supporting nonsurgical periodontal therapy in patients affected by untreated severe periodontitis: A preliminary randomized, triple-blind, placebo-controlled study. Journal of Periodontal Research , 55(1), 61-67. doi:10.1111/jre.12686 [ Links ]

Tonetti, M. S., Eickholz, P., Loos, B. G., Papapanou, P., van der Velden, U., Armitage, G., Suvan, J. E. (2015). Principles in prevention of periodontal diseases: Consensus report of group 1 of the 11th European Workshop on Periodontology on effective prevention of periodontal and peri-implant diseases. Journal of Clinical Periodontology , 42 Suppl 16, S5-11. doi:10.1111/jcpe.12368 [ Links ]

Tonetti, M. S., Greenwell, H., & Kornman, K. S. (2018). Staging and grading of periodontitis: Framework and proposal of a new classification and case definition. Journal of Clinical Periodontology , 45 Suppl 20, S149-S161. doi:10.1111/jcpe.12945 [ Links ]

Tonetti, M. S., Jepsen, S., Jin, L., & Otomo-Corgel, J. (2017). Impact of the global burden of periodontal diseases on health, nutrition and wellbeing of mankind: A call for global action. Journal of Clinical Periodontology , 44(5), 456-462. doi:10.1111/jcpe.12732 [ Links ]

Tonetti, M. S., & Sanz, M. (2019). Implementation of the new classification of periodontal diseases: Decision-making algorithms for clinical practice and education. Journal of Clinical Periodontology , 46(4), 398-405. doi:10.1111/jcpe.13104 [ Links ]

Trombelli, L., Farina, R., Franceschetti, G., & Calura, G. (2009). Single-flap approach with buccal access in periodontal reconstructive procedures. Journal of Periodontology , 80(2), 353-360. doi:10.1902/jop.2009.080420 [ Links ]

Trombelli, L., Farina, R., Pollard, A., Claydon, N., Franceschetti, G., Khan, I., & West, N. (2020). Efficacy of alternative or additional methods to professional mechanical plaque removal during supportive periodontal therapy. A systematic review and meta-analysis. Journal of Clinical Periodontology . doi:10.1111/jcpe.13269 [ Links ]

Trombelli, L., Franceschetti, G., & Farina, R. (2015). Effect of professional mechanical plaque removal performed on a long-term, routine basis in the secondary prevention of periodontitis: a systematic review. Journal of Clinical Periodontology , 42 Suppl 16, S221-236. doi:10.1111/jcpe.12339 [ Links ]

Van der Velden, U., & Sanz, M. (2010). Postgraduate periodontal education. Scope, competences, proficiencies and learning outcomes: consensus report of the 1st European Workshop on Periodontal Education--position paper 3 and consensus view 3. European Journal of Dental Education , 14 Suppl 1, 34-40. doi:10.1111/j.1600-0579.2010.00622.x [ Links ]

van der Weijden, F. A., & Slot, D. E. (2011). Oral hygiene in the prevention of periodontal diseases: the evidence. Periodontology 2000, 55(1), 104-123. doi:10.1111/j.1600-0757.2009.00337.x. [ Links ]

Van der Weijden, F. A., & Slot, D. E. (2015). Efficacy of homecare regimens for mechanical plaque removal in managing gingivitis: a metareview. Journal of Clinical Periodontology , 42 Suppl 16, S77-91. doi:10.1111/jcpe.12359 [ Links ]

van Steenberghe, D., Lekholm, U., Bolender, C., Folmer, T., Henry, P., Herrmann, I., Astrand, P. (1990). Applicability of osseointegrated oral implants in the rehabilitation of partial edentulism: a prospective multicenter study on 558 fixtures. International Journal of Oral and Maxillofacial Implants, 5(3), 272-281. [ Links ]

Villalbi, J. R., Suelves, J. M., Martinez, C., Valverde, A., Cabezas, C., & Fernandez, E. (2019). [Smoking control in Spain: current situation and priorities]. Rev Esp Salud Publica, 93. [ Links ]

Ximénez-Fyvie, L. A., Haffajee, A. D., Som, S., Thompson, M., Torresyap, G., & Socransky, S. S. (2000). The effect of repeated professional supragingival plaque removal on the composition of the supra- and subgingival microbiota. Journal of Clinical Periodontology , 27(9), 637-647. doi:10.1034/j.1600-051x.2000.027009637.x [ Links ]

Xue, D., Tang, L., Bai, Y., Ding, Q., Wang, P., & Zhao, Y. (2017). Clinical efficacy of photodynamic therapy adjunctive to scaling and root planing in the treatment of chronic periodontitis: A systematic review and meta-analysis. Photodiagnosis and Photodynamic Therapy, 18, 119-127. doi:10.1016/j.pdpdt.2017.01.183 [ Links ]

Zare Javid, A., Seal, C. J., Heasman, P., & Moynihan, P. J. (2014). Impact of a customised dietary intervention on antioxidant status, dietary intakes and periodontal indices in patients with adult periodontitis. Journal of Human Nutrition and Dietetics, 27(6), 523-532. doi:10.1111/jhn.12184 [ Links ]

Zhou, X., Lin, M., Zhang, D., Song, Y., & Wang, Z. (2019). Efficacy of Er:YAG laser on periodontitis as an adjunctive non-surgical treatment: A split-mouth randomized controlled study. J Clin Periodontol, 46(5), 539-547. doi:10.1111/jcpe.13107 [ Links ]

Carra, M. C., Detzen, L., Kitzmann, J., Woelber, J. P., Ramseier, C. A., & Bouchard, P. (2020). Promoting behavioural changes to improve oral hygiene in patients with periodontal diseases: a systematic review. Journal of Clinical Periodontology . doi:10.1111/jcpe.13234 [ Links ]

Dommisch, H., Walter, C., Dannewitz, B., & Eickholz, P. (2020). Resective surgery for the treatment of furcation involvement - a systematic review. Journal of Clinical Periodontology . doi:10.1111/jcpe.13241 [ Links ]

Donos, N., Calciolari, E., Brusselaers, N., Goldoni, M., Bostanci, N., & Belibasakis, G. N. (2019). The adjunctive use of host modulators in non-surgical periodontal therapy. A systematic review of randomized, placebo-controlled clinical studies. Journal of Clinical Periodontology . doi:10.1111/jcpe.13232 [ Links ]

Figuero, E., Roldan, S., Serrano, J., Escribano, M., Martin, C., & Preshaw, P. M. (2019). Efficacy of adjunctive therapies in patients with gingival inflammation. A systematic review and meta-analysis. Journal of Clinical Periodontology . doi:10.1111/jcpe.13244 [ Links ]

German Association of the Scientific Medical Societies (AWMF), & Standing Guidelines Commission. (2012). AWMF Guidance Manual and Rules for Guideline Development . Retrieved from (accessed on 03.13.2020) website: 2020) website: http://www.awmf.org/leitlinien/awmf-regelwerk.htmlLinks ]

Herrera, D., Matesanz, P., Martin, C., Oud, V., Feres, M., & Teughels, W. (2020). Adjunctive effect of locally delivered antimicrobials in periodontitis therapy. A systematic review and meta-analysis. Journal of Clinical Periodontology . doi:10.1111/jcpe.13230 [ Links ]

Jepsen, S., Gennai, S., Hirschfeld, J., Kalemaj, Z., Buti, J., & Graziani, F. (2019). Regenerative surgical treatment of furcation defects: A systematic review and Bayesian network meta-analysis of randomized clinical trials. Journal of Clinical Periodontology . doi:10.1111/jcpe.13238 [ Links ]

Nibali, L., Koidou, V. P., Nieri, M., Barbato, L., Pagliaro, U., & Cairo, F. (2019). Regenerative surgery versus access flap for the treatment of intrabony periodontal defects. A systematic review and meta-analysis. Journal of Clinical Periodontology . doi:10.1111/jcpe.13237 [ Links ]

Polak, D., Wilensky, A., Antonoglou, G. N., Shapira, L., Goldstein, M., & Martin, C. (2020). The Efficacy of Pocket Elimination/Reduction Compared to Access Flap Surgery: A Systematic Review and Meta-analysis. Journal of Clinical Periodontology . doi:10.1111/jcpe.13246 [ Links ]

Ramseier, C. A., Woelber, J. P., Kitzmann, J., Detzen, L., Carra, M. C., & Bouchard, P. (2020). Impact of risk factor control interventions for smoking cessation and promotion of healthy lifestyles in patients with periodontitis: a systematic review. Journal of Clinical Periodontology . doi:10.1111/jcpe.13240 [ Links ]

Salvi, G. E., Stahli, A., Schmidt, J. C., Ramseier, C. A., Sculean, A., & Walter, C. (2019). Adjunctive laser or antimicrobial photodynamic therapy to non-surgical mechanical instrumentation in patients with untreated periodontitis. A systematic review and meta-analysis. Journal of Clinical Periodontology . doi:10.1111/jcpe.13236 [ Links ]

Sanz-Sanchez, I., Montero, E., Citterio, F., Romano, F., Molina, A., & Aimetti, M. (2020). Efficacy of access flap procedures compared to subgingival debridement in the treatment of periodontitis. A systematic review and meta-analysis. Journal of Clinical Periodontology . doi:10.1111/jcpe.13259 [ Links ]

Slot, D. E., Valkenburg, C., & van der Weijden, F. (2020). Mechanical plaque removal of periodontal maintenance patients -A systematic review and network meta-analysis. Journal of Clinical Periodontology , in press. [ Links ]

Suvan, J., Leira, Y., Moreno, F., Graziani, F., Derks, J., & Tomasi, C. (2019). Subgingival Instrumentation for Treatment of Periodontitis. A Systematic Review. Journal of Clinical Periodontology . doi:10.1111/jcpe.13245 [ Links ]

Teughels, W., Feres, M., Oud, V., Martin, C., Matesanz, P., & Herrera, D. (2020). Adjunctive effect of systemic antimicrobials in periodontitis therapy. A systematic review and meta-analysis. Journal of Clinical Periodontology . doi:10.1111/jcpe.13264 [ Links ]

Tonetti, M. S., Greenwell, H., & Kornman, K. S. (2018). Staging and grading of periodontitis: Framework and proposal of a new classification and case definition. Journal of Clinical Periodontology , 45 Suppl 20, S149-S161. doi:10.1111/jcpe.12945 [ Links ]

Trombelli, L., Farina, R., Pollard, A., Claydon, N., Franceschetti, G., Khan, I., & West, N. (2020). Efficacy of alternative or additional methods to professional mechanical plaque removal during supportive periodontal therapy. A systematic review and meta-analysis. Journal of Clinical Periodontology . doi:10.1111/jcpe.13269 [ Links ]

Autor para correspondencia: Mariano Sanz | Grupo de Investigación ETEP (Etiología y Terapéutica de las Enfermedades Periodontales y Periimplantarias) Facultad de Odontología, Universidad Complutense de Madrid, Plaza Ramón y Cajal s/n (Ciudad Universitaria) 28040 Madrid, España. | E-mail: marsan@ucm.es | Télefono:+34 91 3942010

Creative Commons License Este es un artículo publicado en acceso abierto bajo una licencia Creative Commons