Appraisal Of Peri-implantitis Guidelines And Cognition Analysis Of Stomatologists In Guangdong Province

Objective:Peri-implantitis is an inflammatory lesion of the soft and hard tissue around the implant,resulting in the loss of the supporting tissue around the implant.Implant-based and patient-based peri-implantitis has a high prevalence rate and is very harmful.If not treated promptly and effectively,it may eventually lead to implantation failure.In recent years,clinical scholars have paid more and more attention to peri-implantitis,and related diagnosis and treatment guidelines or expert consensus have been formulated.However,there is still no unified standard for the definition,diagnosis and treatment of peri-implantitis.The quality of the guidelines is uneven,some guidelines even do not meet the most basic standards,and can not be directly used in local clinical practice;At the same time,most oral clinicians do not know or do not follow the guidelines for clinical practice,and the above factors directly affect the potential benefits of patients.Therefore,the objective of this study was to evaluate the methodological quality of the peri-implantitis guidelines and to understand the perception of the recommended content of the peri-implantitis guidelines among stomatologists in Guangdong Province.Methods:1.Appraisal on guideline qualityA systematic review of the literature of clinical practice guidelines following Preferred Reporting Items for Systematic Reviews and Meta-Analyses was conducted.We searched for guidelines or consensus on prevention,diagnosis,and/or treatment of peri-implantitis through Pub Med,Web of Science,Cochrane Library until March 15^th,2022.In addition,we also searched official websites of the American Dental Association,International Team for Implantology,FDI World Dental Federation,and some guideline collection databases.Assessment of selected CPGs was performed using the Appraisal of Guidelines for Research&Evaluation II methodological quality instrument（AGREE II）.Furtherly,we described the consistency of recommendations across the included guidelines.2.Design and issue awareness questionnaireElectronic questionnaire was used to investigate the basic information of stomatologists,cognition and clinical response.Questionnaires were sent to oral departments of parts of hospitals in Guangzhou,Foshan,Dongguan,Zhongshan,Jiangmen and Zhuhai of Guangdong province through e-mail,and the data were input by Epi Data 3.1 softwareResults:1.Methodological quality of peri-implantitis guidelineIn total,15 guidelines were included in this study.Mean values of the six domains score were all below 50%,and Applicability scores lowest（mean:15%,range:4%–29%）.As to the overall quality,eleven（73%）were recommended after modification,and four（27%）were not recommended.Among the clinical recommendations,53（67.09%）are for treatment of peri-implantitis,13（16.46%）for monitoring issue,7（8.86%）for diagnosis of peri-implantitis,3（3.80%）for the disease prevention.2.Cognition on periimplantitis guidelines among Stomatologists in Guangdong ProvinceA total of 209 valid questionnaires were collected,most of the subjects came from public hospitals（64.1%）.The proportion of Grade-A tertiary hospital was high（56.2%）,and most of the subjects（87.6%）had a bachelor’s degree or above.First,in terms of self-cognition,97（46.4%）subjects claimed they knew well on peri-implantitis CPG.Second,there was a statistically significant difference in the recognition score of clinical problems among dentists with different education levels（F=12.26,P=0.02）.Thirdly,in terms of clinical response,the average accuracy rate of the 8 key clinical recommendations was 42.6%,and 2 of which was lower than20%.Conclusions:1.Improving methodology quality and strengthening clinical evidence is essential in the future guideline development in a range of disciplines for improving the treatment effectiveness of people with peri-implantitis.And there is a lack of integrated guidelines in the case of the COVID-19 pandemic.2.Stomatologists in Guangdong province did not know well on Peri-implantitis guidelines,especially among young doctors.In addition,the cognitive level of clinical recommendations is not ideal,mainly in the diagnosis and treatment of peri-implantitis.In order to fully understand the awareness of peri-implantitis guidelines among stomatologists in China,the cognition survey should be carried out in an orderly manner in the future...