Review of clinical practice guidelines on the diagnosis and treatment of third molars. Evaluation of adherence to AGREE II publication guideline

Abstract

Background: Clinical practice guidelines (CPG) are developed to summarize the available evidence for healthcare professionals and standardize decisions in the clinical setting. For them to be useful, they must be generated following systematic methods, have high scope and applicability, present information clearly, and be updated every five years. The main aim of this review was to evaluate the available CPGs on the diagnosis and treatment of third molars (3M) using the AGREE II instrument to assess their quality and strength of recommendations. Material and Methods: An electronic search was conducted using the PubMed (MEDLINE), Cochrane Library, and Scopus databases. Additionally, a manual search was performed by international health organizations and dental and surgical associations. The inclusion criterion was CPG published in the last 5 years on the diagnosis and treatment of 3M. The quality of the guidelines was analyzed using the AGREE II instrument. Results: 14 CPGs were identified; However, only seven met the inclusion criteria. The guidelines from the Spanish Society of Oral Surgery (SECIB) and the Malaysia Oral Health Programme (MOHP) were considered high-quality. In contrast, guidelines from the German Medical Association (DGMKG), French Society of Stomatology MaxilloFacial Surgery and Oral Surgery (SFSCMFCO) and Royal College of Surgeons of England (RCSE) were rated as moderate quality and recommended with modifications. The Finnish Medical and Dental Society (FMDS) and Dutch Association of Oral and Maxillofacial Surgeons (NVMKA) did not meet the minimum quality standards. Conclusions: The AGREE II analysis reveals a need for substantial improvement in third molar CPGs. Only two guidelines were rated as high-quality, with most being outdated or soon to be. Regular updates by guideline-developing organizations are essential to ensure accurate and relevant clinical recommendations.