Management of Acute Periodontal Conditions—The EFP S2k Level Clinical Practice Guideline

BACKGROUND: The European Federation of Periodontology (EFP) has developed Clinical Practice Guidelines (CPGs) for the treatment of periodontitis and for the management of peri-implant diseases. In accordance with the 2018 Classification, acute periodontal conditions are characterised by rapid-onset pain or discomfort, tissue destruction and infection. Therefore, the development of a CPG to guide patients and clinicians in their management is justified. AIM: To develop an S2k-level CPG for the management of acute periodontal conditions, necrotising periodontal diseases, periodontal abscesses and acute manifestations of endodontic-periodontal lesions. METHODS: This S2k-level CPG was developed by the 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 two commissioned systematic reviews, evaluation of the quality and strength of evidence, formulation of specific recommendations and a structured consensus process involving leading experts and a broad base of stakeholders. Recommendations were based on the best available evidence, combined with structured expert consensus, particularly in areas where direct evidence remains scarce. RESULTS: The S2k-level CPG for the management of acute periodontal conditions presents a structured approach, grouping the recommendations in three successive steps: (1) confirming diagnosis, following the case definitions of the 2018 classification; (2) initial treatment, to control the acute condition including pain and active tissue destruction; and (3) subsequent treatments, to manage the pre-existing conditions and prevent the risk of disease recurrence and/or control the potential sequelae. CONCLUSION: The present S2k-level CPG informs clinical practice, health systems, policymakers and, indirectly, the public on the available and most effective interventions in the management of acute periodontal conditions.

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Journal
Journal Of Clinical Periodontology
Published
2026-09-09
DOI
https://doi.org/10.1111/jcpe.70166
Primary Topic
Oral microbiology and periodontitis research
Type
article
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article

Management of Acute Periodontal Conditions—The EFP S2k Level Clinical Practice Guideline

Henrik Dommisch, Elena Calciolari, Raluca Cosgarea, Marjolaine Gosset et al.
Journal Of Clinical Periodontology
Oral microbiology and periodontitis research
article

Management of Acute Periodontal Conditions—The EFP S2k Level Clinical Practice Guideline

Henrik Dommisch, Elena Calciolari, Raluca Cosgarea, Marjolaine Gosset, Panos N. Papapanou, Roberto Fariña, Nagihan Bostancı, Peter Eickholz, Rodrigo López, Maurizio S. Tonetti, Mario Aimetti, Nicola Discepoli, Lior Shapira, Paula Matesanz, Darko Božić, Leonardo Trombelli, Asaf Wilensky, Moshe Goldstein, Ivan Alajbeg, Cristiano Tomasi, Andreas Stavropoulos, Tali Chackartchi, Wim Teughels, Philippe Bouchard, Nerea Sánchez, Joerg Meyle, Nikolaos Donos, Dagmar Else Slot, Moritz Kebschull, Selena Toma, Niklaus P. Lang, A. Molina, Sören Jepsen, Ioannis Polyzois, Anton Sculean, Nurcan Buduneli, Jan Derks, Phoebus Madianos, Mariano Sanz, Iain Chapple, Philip Preshaw, Evangelia Zampa, Elena Figuero, maria geisinger, michele davide mignogna, Ellen Bol - van den Hil, David Herrera, Dagmar Fossa Bunæs, marco meleti, Bahar Eren Kuru, Christoph Dörfer, fridus van der Weijden, Filippo Graziani, laura ceballos, spyros vassilopoulos, Nicola X West, Juan Blanco, helena frannson, ezgi yesiltan, Mia Rakic, Georgios Belibasakis, Bruno G Loos, Eduardo Montero, Ignacio Sanz Sánchez, jean suvan, helena francisco, Peter Windisch, Andrea Pilloni, Ulvi K. Gursoy, Luigi Nibali, monique danser, Ricardo Faria-Almeida, Maria Clotilde Carra, Methodological Consultant
article en

Abstract

BACKGROUND: The European Federation of Periodontology (EFP) has developed Clinical Practice Guidelines (CPGs) for the treatment of periodontitis and for the management of peri-implant diseases. In accordance with the 2018 Classification, acute periodontal conditions are characterised by rapid-onset pain or discomfort, tissue destruction and infection. Therefore, the development of a CPG to guide patients and clinicians in their management is justified. AIM: To develop an S2k-level CPG for the management of acute periodontal conditions, necrotising periodontal diseases, periodontal abscesses and acute manifestations of endodontic-periodontal lesions. METHODS: This S2k-level CPG was developed by the 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 two commissioned systematic reviews, evaluation of the quality and strength of evidence, formulation of specific recommendations and a structured consensus process involving leading experts and a broad base of stakeholders. Recommendations were based on the best available evidence, combined with structured expert consensus, particularly in areas where direct evidence remains scarce. RESULTS: The S2k-level CPG for the management of acute periodontal conditions presents a structured approach, grouping the recommendations in three successive steps: (1) confirming diagnosis, following the case definitions of the 2018 classification; (2) initial treatment, to control the acute condition including pain and active tissue destruction; and (3) subsequent treatments, to manage the pre-existing conditions and prevent the risk of disease recurrence and/or control the potential sequelae. CONCLUSION: The present S2k-level CPG informs clinical practice, health systems, policymakers and, indirectly, the public on the available and most effective interventions in the management of acute periodontal conditions.

Journal Of Clinical Periodontology
Yeditepe University (TR), Semmelweis University (HU), University of Siena (IT), University of Pisa (IT), Goethe University Frankfurt (DE), University of Bern (CH), Universidad Complutense de Madrid (ES), University of Parma (IT), Birmingham City University (GB), Cliniques Universitaires Saint-Luc (BE), University of Lisbon (PT), University of Turku (FI), Queen Mary University of London (GB), University of Dundee (GB), University of Zagreb (HR), Universidad Rey Juan Carlos (ES), Universidade do Porto (PT), Shanghai Jiao Tong University (CN), Malmö University (SE), King's College London (GB), Hebrew University of Jerusalem (IL), Universidade de Santiago de Compostela (ES), Justus-Liebig-Universität Gießen (DE), National and Kapodistrian University of Athens (GR), University of Ferrara (IT), Université Paris Cité (FR), University Hospital Bonn (DE), Hadassah Medical Center (IL), University Of Bristol Dental Hospital (GB), Birmingham Community Healthcare NHS Trust (GB), American Dental Hygienists' Association (US), Karolinska Institutet (SE), Academic Center for Dentistry Amsterdam (NL), Christian-Albrechts-Universität zu Kiel (DE), University of Alabama at Birmingham (US), Humboldt-Universität zu Berlin (DE), Sorbonne Université (FR), Ege University (TR), Hôpital Rothschild (FR), Laboratory Orofacial Pathologies, Imaging and Biotherapies (FR), Shanghai Ninth People's Hospital (CN), Federico II University Hospital (IT), Dublin Dental University Hospital (IE), Giessen School of Theology (DE), NIHR Birmingham Biomedical Research Centre (GB), University of Bergen (NO), University of Turin (IT), University of Naples Federico II (IT), Columbia University (US), University of Glasgow (GB), University of Birmingham (GB), Sapienza University of Rome (IT), Vrije Universiteit Amsterdam (NL), University of Gothenburg (SE), University of Amsterdam (NL), KU Leuven (BE)
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Oral microbiology and periodontitis research
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