The effect of horizontal and vertical furcation involvement on molar survival: A retrospective study

Abstract

Attention should be placed on both horizontal and vertical FI in molars, owing to their association with tooth loss during SPT.

The importance of supportive periodontal therapy for molars treated with furcation tunnelling

“…Having shorter root trunk length and larger divergence between roots, first mandibular molars are anatomically the most suitable candidates for the tunnelling procedure (Chiu, Zee, Corbet, & Holmgren, 1991;Hou & Tsai, 1997;Kerns et al, 1999;Muller & Eger, 1999;Paolantonio, Placido, Scarano, & Piattelli, 1998). The average root trunk length in patients included in this study was 3.6 mm as measured radiographically, substantially less than what was measured with the same methods in a group of aggressive periodontitis and healthy subjects in a previous study (6.5 mm and 7.1 mm, respectively; Nibali, Sun, et al, 2018b), maybe reflecting both the higher risk of furcation involvement in molars with short root trunk (Hou & Tsai, 1997) and the operators' choice to perform tunnelling surgeries in cases with short root trunk, easier to access for oral hygiene manoeuvres.…”

Papilla preservation flaps for periodontal regeneration of molars severely compromised by combined furcation and intrabony defects: Retrospective analysis of a registry‐based cohort

“…In this group, 10‐year survival of furcated molars was 91% for cases with baseline clinical AL limited to the coronal third of the root, decreased to 67% for teeth with clinical AL extending to the middle third and was a mere 23% for teeth with baseline clinical AL extending into the apical third of the root. An important confirmation from an independent study strengthens the hypothesis that loss/extraction of furcated molars involves consideration of the residual support of the furcated molar . Indeed, the integration of clinical and radiographic estimates of both horizontal (Class I to III according to Hamp et al …”

“…These data confirm observations from previous reports 12,13 and extend them to provide direct evidence that regeneration is able to provide improvement in vertical subclassification of furcation involvement. 6 Two recent studies have indicated that vertical subclassification of furcation involvement is associated with tooth retention 7,8 : a furcated molar is lost or extracted more frequently and sooner if the periodontal breakdown affects the apical portion of one of the roots (subclass C). In this study, besides the improvements in horizontal furcation involvement (Tables 2-4 Randomized controlled clinical trials need to be conducted to establish the benefits of periodontal regeneration aimed at improving vertical periodontal support of furcated molars with deep intrabony defects.…”

“…An important confirmation from an independent study strengthens the hypothesis that loss/extraction of furcated molars involves consideration of the residual support of the furcated molar. 8 Indeed, the integration of clinical and radiographic estimates of both horizontal (Class I to III according to Hamp et al 5 ) and vertical (subclass A to C according to Tarnow and Fletcher 6 ) is the key to diagnosis, prognosis, and treatment planning of the compromised molar. As the vertical compromise of each root increases, classical approaches have emphasized root separation and resection techniques and, in more advanced stages, tooth extraction.…”

A Controlled Study on the Diagnostic Accuracy of Panoramic and Peri-Apical Radiography for Detecting Furcation Involvement

“…Essentially, treatment of FI may involve periodontal regeneration, root resection, amputation, tunneling techniques and tooth extraction(38)(39)(40)(41) (42). Prognostically, the vertical component increases the risk of tooth loss signi cantly (43) and needs to be regarded as a risk factor in personalized maintenance programs (44). Third, CBCT was used as gold standard because of ethical restrictions.…”