Tooth loss in molars with and without furcation involvement – a systematic review and meta‐analysis

Abstract

The presence of FI approximately doubles the risk of tooth loss for molars maintained in supportive periodontal therapy for up to 10-15 years. However, most molars, even with grade III FI respond well to periodontal therapy, suggesting that every effort should be made to maintain these teeth when possible. Long-term studies reporting patient-reported outcomes are needed to substantiate this conclusion.

A retrospective study on periodontal disease progression in private practice

“…The risk of tooth loss for molars with FI undergoing SPT was estimated to be 2–4 times higher than molars with no FI in a recent systematic review (Nibali et al. ) and this was confirmed in the current paper. Specific details and data on furcation treatment will be presented in a separate publication.…”

The effect of furcation involvement on tooth loss in a population without regular periodontal therapy

“…Previous studies on patients undergoing periodontal treatment reported a 43‐100% survival for molars with FI after a follow‐up of 5 to 53 years (Checchi, Montevecchi, Gatto, & Trombelli, ; Dannewitz, Krieger, Husing, & Eickholz, ; Dannewitz et al., ; Goldman, Ross, & Goteiner, ; Graetz et al., ; Hirschfeld & Wasserman, ; McFall, ; McGuire & Nunn, ; Miller, McEntire, Marlow, & Gellin, ; Pretzl, Kaltschmitt, Kim, Reitmeir, & Eickholz, ; Salvi et al., ; Wang, Burgett, Shyr, & Ramfjord, ; Wood, Greco, & McFall, ). The overall risk of molar tooth loss attributable to furcation involvement has been estimated to be 1.53 for studies up to 10 years of follow‐up in a recent systematic review (OR=2.71 for studies with 10‐15 years follow‐up) (Nibali et al., ). In the present study, the adjusted IRR due to FI was similar (overall 2.17 for worst FI).…”

“…A recent systematic review pointed out that FI increases the risk of tooth loss in patients undergoing supportive periodontal care (Nibali et al., ). However, most molars were retained long term, even in presence of degree II or III FI.…”

Treatment of grade III furcation lesion by tunneling in a smoker patient: Clinical Case Report

“…Furcation lesions have been considered a challenge for periodontal treatment because it is a therapy of poorly predictable clinical results and because the teeth are more lost during periodontal support therapy 3 , thus being a classic indication for replacement of this dental element by a prosthesis supported by an osseointegrated implant 8 . However, even today there are several factors that can lead to the choice of periodontal therapy to maintain the tooth instead of replacing it with a dental implant, such as economic reasons, the patient's desire to maintain the tooth and the presence of systemic diseases or behavior that leaves the patient at risk of failure for implant therapy 9 (9).…”

“…When the prognosis of periodontal disease progresses in the molar teeth, it is common for the involvement of the furcation regions to occur, which impairs the prognosis of these dental elements 2 . In fact, it has been shown that teeth with furcation are the most lost in patients in periodontal support therapy and because of this, teeth with a worse prognosis are considered regarding the outcome of periodontal therapy 3 . Thus, it is not uncommon to recommend the extraction of teeth with furcation involvement for subsequent dental implants.…”