ABSTRACT
Periodontal disease is considered a public health problem due to its high prevalence worldwide. Currently, the treatment of periodontal disease is not always successful due to many aspects, including non-compliance with scheduled appointments by the patient. Several authors over the years have evaluated different factors that could be related to non-compliance with periodontal treatment, so the objective of this narrative review of the literature was to explore and analyze the factors that may be related to compliance with periodontal treatment appointments. The results obtained allowed us to conclude that compliance by the patient will depend on a series of multiple factors, however, such compliance will favor the outcome of the periodontal treatment. Key words:Patient Compliance, Treatment Adherence, Periodontal Diseases, (MeSH).
ABSTRACT
Resumen La diferencia entre la prevalencia de la enfermedad periodontal en América Latina y las reportadas en otras regiones del mundo, podría estar explicada en parte por las características culturales, políticas y económicas propias de cada territorio. Además, la exposición e interacción de factores e indicadores de riesgo pueden variar en cada región. Hasta el momento no se ha reportado alguna revisión de literatura ni revisión sistemática sobre los factores e indicadores de riesgo presentes y estudiados en Latinoamérica. El objetivo de esta revisión narrativa es reportar la evidencia disponible sobre las condiciones modificadoras del riesgo (indicadores y factores de riesgo) que se han estudiado en la población latinoamericana, y proponer recomendaciones para las futuras investigaciones que permitan realizar revisiones sistemáticas en esta región. A partir de los hallazgos de esta revisión, los autores consideran que es necesario aumentar las publicaciones científicas, y especialmente la investigación analítica sobre factores de riesgo y sus interacciones con las particularidades propias de cada país latinoamericano, siguiendo metodologías estándar basadas en la nueva clasificación de la enfermedad periodontal para que en un futuro sea posible recopilar esta información en revisiones sistemáticas sobre factores de riesgo.
Abstract The difference between the prevalence of periodontal disease in Latin America and those reported in other regions of the world, could be explained in part by the cultural, political and economic characteristics of each territory. Furthermore, the exposure and interaction of risk factors and indicators may be different in each region. So far, no literature review or systematic review has been reported on the risk factors and indicators present and studied in Latin America. The aim of this narrative review is to report the available evidence on the risk modifying conditions (indicators and risk factors) that have been studied in the Latin American population, and to give recommendations for future research in the region that will allow for systematic reviews in the context of our region. Based on the findings of this review, the authors consider that it is necessary to increase scientific publications, especially analytical research on risk factors and their interactions with the specific characteristics of each Latin American country, following standard methodologies based on the new classification of the disease. periodontal so that in the future it is possible to compile this information in systematic reviews on risk factors.
Resumo A diferença entre a prevalência da doença periodontal na América Latina e as relatadas em outras regiões do mundo pode ser parcialmente explicada pelas características culturais, políticas e econômicas de cada território. Além disso, a exposição e interação dos fatores e indicadores de risco podem variar em cada região. Até o momento, nenhuma revisão de literatura ou revisão sistemática foi relatada sobre os fatores e indicadores de risco presentes e estudados na América Latina. O objetivo desta revisão narrativa é relatar as evidências disponíveis sobre as condições modificadoras de risco (indicadores e fatores de risco) que têm sido estudadas na população latino-americana e propor recomendações para pesquisas futuras que permitam revisões sistemáticas nesta região. Com base nos resultados desta revisão, os autores consideram que é necessário aumentar as publicações científicas, e principalmente as pesquisas analíticas sobre os fatores de risco e suas interações com as particularidades de cada país latino-americano, seguindo metodologias padronizadas baseadas na nova classificação da doença periodontal para que futuramente seja possível coletar essas informações em revisões sistemáticas sobre fatores de risco.
ABSTRACT
ABSTRACT Introduction: the incidence of peri-implant diseases is high, and their optimal management is still debated. The purpose was to explore the levels of available evidence and to suggest evidence-based recommendations for the treatment of peri-implant mucositis and peri-implantitis. Methods: a clinical practice guideline was developed using the Scottish Intercollegiate Guidelines Network (SIGN) criteria. A search strategy was formulated, and a critical review of the following evidence was performed: 1) prevention of peri-implant diseases, 2) treatment of peri-implant mucositis, and 3) treatment of peri-implantitis. Systematic reviews and randomized controlled clinical trials were the primary study types identified in the literature. Current levels of evidence were established and recommendations were provided. Results: a total of 67 articles were included. Regarding the prevention of peri-implant diseases, there is strong evidence for the involvement of patients in a regular maintenance program according to their risk profile. Regarding the treatment of peri-implant mucositis, infection control measures are recommended; controversy exists over the usefulness of antimicrobial agents, and there is evidence against the use of antibiotics. Selection of the peri-implantitis treatment method depends on the severity of the condition and patient-related factors. Resective and regenerative therapies may be used for treatment. The use of systemic antibiotics favors the response of clinical parameters. There is conditional evidence for the use of other adjunctive therapies. Conclusions: the best way to prevent peri-implantitis is to prevent peri-implant mucositis through adherence to supportive periodontal therapy. Treatment of peri-implant diseases depends on local and systemic conditions that affect the success of other treatment options.
RESUMEN Introducción: la incidencia de las enfermedades periimplantarias es alta, y todavía existe polémica en torno a su óptima administración. El propósito del presente estudio consistió en explorar los niveles de evidencia disponibles y ofrecer recomendaciones basadas en la evidencia para el tratamiento de la mucositis periimplantaria y la periimplantitis. Métodos: se elaboró una guía de práctica clínica utilizando los criterios de la Red de Directrices Intercolegiales Escocesas (Scottish Intercollegiate Guidelines Network, SIGN). Se formuló una estrategia de búsqueda y se realizó una revisión crítica de las siguientes evidencias: 1) prevención de enfermedades periimplantarias, 2) tratamiento de la mucositis periimplantaria y 3) tratamiento de la periimplantitis. Las revisiones sistemáticas y los ensayos clínicos controlados aleatorios fueron los principals tipos de estudio identificados en la literatura. Se establecieron los niveles actuales de evidencias y se ofrecieron recomendaciones. Resultados: se incluyeron 67 artículos. En cuanto a la prevención de enfermedades periimplantarias, hay claras evidencias de la participación de los pacientes en los programas de mantenimiento regular, de acuerdo con su perfil de riesgo. En cuanto al tratamiento de la mucositis periimplantaria, se recomiendan medidas de control de infecciones; existe controversia sobre la utilidad de los agentes antimicrobianos, y hay evidencia en contra del uso de antibióticos. La selección del método de tratamiento de la periimplantitis depende de la gravedad de la afección y de los factores relacionados con el paciente. Para el tratamiento se pueden utilizar terapias resectivas y regenerativas. El uso de antibióticos sistémicos favorece la respuesta de los parámetros clínicos. Hay evidencia condicional en cuanto al uso de otras terapias adyuvantes. Conclusiones: la mejor manera de prevenir la periimplantitis es prevenir la mucositis periimplantar mediante la adherencia a la terapia periodontal de apoyo. El tratamiento de las enfermedades periimplantarias depende de las condiciones locales y sistémicas que afectan el éxito de otras opciones de tratamiento.
