Systematic review of clinical practice guidelines for traumatic dental injuries

Saikia A 1 , Patil SS 1 , Ms M 1 , Cv D 2 , Sabarish R 3 , Pandian S 4 Show all authors , Anthonappa R 5 , Walia T 6 , Shahwan MJSA 7

Affiliations 

  • 1 Department of Pediatric and Preventive Dentistry, Sri Ramachandra Faculty of Dental Sciences, Centre for Early Childhood Caries Research (CECCRe), Sri Ramachandra Institute of Higher Education and Research (SRIHER), Porur, Chennai, 600116, India
  • 2 Department of Oral Medicine and Radiology, Sri Ramachandra Faculty of Dental Sciences, Sri Ramachandra Institute of Higher Education and Research (DU), Porur, Chennai, 600116, India
  • 3 Department of Periodontology, Sri Ramachandra Faculty of Dental Sciences, Sri Ramachandra Institute of Higher Education and Research, Porur, Chennai, 600116, India
  • 4 Specialist Oral and Maxillofacial Surgeon, Dentacare Centre, Abudhabi, United Arab Emirates
  • 5 Dental School, Oral Developmental and Behavioural Sciences, The University of Western Australia, Sterling Highway, Perth, Western Australia, Australia
  • 6 College of Dentistry, Ajman University, Ajman, United Arab Emirates
  • 7 Centre of Medical and Bio-allied Health Science Research (CMBHSR), College of Pharmacy and Health Sciences (COPHS), Ajman University, Ajman, United Arab Emirates
Dent Traumatol, 2023 Aug;39(4):371-380.
PMID: 36920339 DOI: 10.1111/edt.12838

Abstract

BACKGROUND/AIMS: Traumatic dental injuries (TDI) are considered a public health problem due to their high prevalence and associated physical, economic, psychological and social consequences. Hence, good Clinical Practice Guidelines are essential to achieving a favourable prognosis. The aim of this review was to appraise the existing Clinical Practice Guidelines (CPGs) on TDI using AGREE II and AGREE-REX.

MATERIALS AND METHODS: A systematic search for existing guidelines on TDI was performed on PubMed, EMBASE, CINAHL, Cochrane Library, ProQuest, National Institute for Health Care Excellence, BMJ Best Practice, Trip database, Guideline International Network, Scottish Intercollegiate Guidelines Network, World Health Organisation, Web of Science and 'Ministry of Health worldwide' databases. Four appraisers independently appraised the included CPGs. The AGREE II tool was applied to assess the methodological quality, while AGREE REX assessed the quality of recommendations of the included guidelines.

RESULTS: Of the 7736 titles screened, three guidelines, namely the International Association of Dental Traumatology Guidelines (IADT), and the Italian and Malaysian guidelines, were included for the final analysis. These guidelines were published between 2019 and 2020. The AGREE II analysis demonstrated scores above 80% for the IADT and Italian guidelines for the scope and purpose domain. Overall, the Malaysian guidelines achieved the highest score for all domains. The AGREE REX analysis indicated variability in implementation across the nine items, with five that scored above the midpoint of 4.0 on the response scale. Both the Italian and the IADT guidelines had a similar score for the values and preference domains (36.36%).

CONCLUSIONS: Several deficiencies exist in the methodological quality of existing CPGs on TDI. Future guidelines should consider improvements for domains such as 'rigour of development', 'stakeholder involvement' and 'applicability' to overcome the existing limitations.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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