Effects of furcation involvement on molar survival in periodontally treated patients

Abstract

Objective: This study aims to analyze the survival time of molar tooth according to furcation involvement (FI) classification among periodontally treated patients under a supportive periodontal care program.
Materials and Methods: A retrospective study was con-ducted among 77 periodontitis patients with 240 molars who had undergone periodontal therapy that were followed up with supportive periodontal therapy (SPT) for at least five years. Periodontitis patients’ data were retrieved from the periodontic clinical record. The clinical parameters of all involved molars and treatment modality were recorded at baseline and SPT.
Results: A total of 69 (28.8%) molars were extracted during active periodontal therapy, while 17 (7.1%) were lost during SPT. The 5-year survival rate of molars was 83.5% (95% confidence interval [CI], 76.9-88.4) for FI=0 (n=141), 81.0% (95% CI, 56.9-92.4) for FI=I (n=18), 50.0% (95% CI, 33.8-64.2) for FI=II (n=21), and 25.0% (95% CI, 6.9-48.8) for FI=III (n=4). Additionally, the 10-year survival rate for molars with FI = III was 12.5% (95% CI, 1.0-39.2), which was lower than that of molars with FI = 0 (77.1%; 95% CI, 69.7-83.0).
Conclusions: The presence of a high degree of FI classifica-tion, especially Class III, is associated with a lower survival rate of molars among periodontally treated patients. Retention of molars is possible on a long-term basis through a maintenance program of periodontal therapy.
Keywords: Furcation defects; Molar; Periodontitis; Survival rate; Tooth loss; Clinical Record.

References

1. Shillingburg HT, Sather DA, Wilson EL, Cain JR, Mitchell DL, Blanco LJ, Kessler JC. Fundamentals of fixed prosthodontics. 4th Edition 2012. UK: Quintessence.

2. Dannewitz B, Krieger JK, Hüsing J, Eickholz P. Loss of molars in periodontally treated patients: a retrospective analysis five years or more after active periodontal treatment. J Clin Periodontol. 2006;33(1):53-61. doi: 10.1111/j.1600-051X.2005.00858.x. PMID: 16367857.

3. Dannewitz B, Zeidler A, Hüsing J, Saure D, Pfefferle T, Eickholz P, Pretzl B. Loss of molars in periodontally treated patients: results 10 years and more after active periodontal therapy. J Clin Periodontol. 2016;43(1):53-62. doi: 10.1111/jcpe.12488. Epub 2016 Feb 5. PMID: 26660235.

4. Nibali L, Zavattini A, Nagata K, Di Iorio A, Lin GH, Needleman I, Donos N. Tooth loss in molars with and without furcation involvement - a systematic review and meta-analysis. J Clin Periodontol. 2016 Feb;43(2):156-66. doi: 10.1111/jcpe.12497. Epub 2016 Feb 12. PMID: 26932323.

5. Costa FO, Cortelli JR, Cortelli SC, Costa AA, Esteves Lima RP, Costa AM, Pereira GHM, Cota LOM. The loss of molars in supportive periodontal care: A 10-year follow-up for tooth- and patient-related factors. J Clin Periodontol. 2022;49(3):292-300. doi: 10.1111/jcpe.13585. Epub 2022 Jan 23. PMID: 34905803.

6. Caton JG, Armitage G, Berglundh T, Chapple ILC, Jepsen S, Kornman KS, Mealey BL, Papapanou PN, Sanz M, Tonetti MS. A new classification scheme for periodontal and peri-implant diseases and conditions - Introduction and key changes from the 1999 classification. J Clin Periodontol. 2018;45 Suppl 20:S1-S8. doi: 10.1111/jcpe.12935. PMID: 29926489.

7. Tonetti MS, Greenwell H, Kornman KS. Staging and grading of periodontitis: Framework and proposal of a new classification and case definition. J Periodontol. 2018;89 Suppl 1:S159-S172. doi: 10.1002/JPER.18-0006. Erratum in: J Periodontol. 2018 Dec;89(12):1475. PMID: 29926952.

8. Mohd Dom TN, Ayob R, Abd Muttalib K, Aljunid SM. National Economic Burden Associated with Management of Periodontitis in Malaysia. Int J Dent. 2016; 2016:1891074. doi: 10.1155/2016/1891074. Epub 2016 Mar 16. PMID: 27092180; PMCID: PMC4820592.

9. Papapanou PN, Sanz M, Buduneli N, Dietrich T, Feres M, Fine DH, Flemmig TF, Garcia R, Giannobile WV, Graziani F, Greenwell H, Herrera D, Kao RT, Kebschull M, Kinane DF, Kirkwood KL, Kocher T, Kornman KS, Kumar PS, Loos BG, Machtei E, Meng H, Mombelli A, Needleman I, Offenbacher S, Seymour GJ, Teles R, Tonetti MS. Periodontitis: Consensus report of workgroup 2 of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions. J Periodontol. 2018;89 Suppl 1:S173-S182. doi: 10.1002/JPER.17-0721. PMID: 29926951.

10. Kwok V, Caton JG. Commentary: prognosis revisited: a system for assigning periodontal prognosis. J Periodontol. 2007;78(11):2063-71. doi: 10.1902/jop.2007.070210. PMID: 17970671.

11. Hamp SE, Nyman S, Lindhe J. Periodontal treatment of multirooted teeth. Results after 5 years. J Clin Periodontol. 1975;2(3):126-35. doi: 10.1111/j.1600-051x.1975.tb01734.x. PMID: 1058213.

12. David M, J CM, M FP, Y. PAP. Sample Size Tables for Clinical Studies (2nd Edn) Blackwell Science; 1997.

13. Nibali L, Sun C, Akcalı A, Meng X, Tu YK, Donos N. A retrospective study on periodontal disease progression in private practice. J Clin Periodontol. 2017;44(3):290-297. doi: 10.1111/jcpe.12653. Epub 2016 Dec 27. PMID: 27883212.

14. Hirschfeld L, Wasserman B. A long-term survey of tooth loss in 600 treated periodontal patients. J Periodontol. 1978;49(5):225-37. doi: 10.1902/jop.1978.49.5.225. PMID: 277674.

15. McFall WT Jr. Tooth loss in 100 treated patients with periodontal disease. A long-term study. J Periodontol. 1982 ;53(9):539-49. doi: 10.1902/jop.1982.53.9.539. PMID: 6957591.

16. Graetz C, Schützhold S, Plaumann A, Kahl M, Springer C, Sälzer S, Holtfreter B, Kocher T, Dörfer CE, Schwendicke F. Prognostic factors for the loss of molars--an 18-years retrospective cohort study. J Clin Periodontol. 2015;42(10):943-50. doi: 10.1111/jcpe.12460. Epub 2015 Oct 26. PMID: 26399690.

17. Hou GL, Lin IC, Tsai CC, Shieh TY. [The study of molar furcation involvements in adult periodontitis. II. Age, sex, location and prevalence]. Kaohsiung J Med Sci. 1996;12(9):514-21. Japanese. PMID: 8819354.

18. Zhang W, Foss K, Wang BY. A retrospective study on molar furcation assessment via clinical detection, intraoral radiography and cone beam computed tomography. BMC Oral Health. 2018;18(1):75. doi: 10.1186/s12903-018-0544-0. PMID: 29724208; PMCID: PMC5934848.

19. Corraini P, Baelum V, Lopez R. Reliability of direct and indirect clinical attachment level measurements. J Clin Periodontol. 2013;40(9):896-905. doi: 10.1111/jcpe.12137. Epub 2013 Jul 21. PMID: 23869826.

20. McGuire MK. Prognosis versus actual outcome: a long-term survey of 100 treated periodontal patients under maintenance care. J Periodontol. 1991;62(1):51-8. doi: 10.1902/jop.1991.62.1.51. PMID: 2002432.

21. Wang HL, Burgett FG, Shyr Y, Ramfjord S. The influence of molar furcation involvement and mobility on future clinical periodontal attachment loss. J Periodontol. 1994;65(1):25-9. doi: 10.1902/jop.1994.65.1.25. PMID: 8133412.

22. McGuire MK, Nunn ME. Prognosis versus actual outcome. II. The effectiveness of clinical parameters in developing an accurate prognosis. J Periodontol. 1996;67(7):658-65. doi: 10.1902/jop.1996.67.7.658. PMID: 8832476.

23. Tonetti MS, Christiansen AL, Cortellini P. Vertical subclassification predicts survival of molars with class II furcation involvement during supportive periodontal care. J Clin Periodontol. 2017;44(11):1140-1144. doi: 10.1111/jcpe.12789. Epub 2017 Sep 22. PMID: 28771794.

24. Nibali L, Akcalı A, Rüdiger SG. The importance of supportive periodontal therapy for molars treated with furcation tunnelling. J Clin Periodontol. 2019;46(12):1228-1235. doi: 10.1111/jcpe.13181. Epub 2019 Oct 21. PMID: 31418893.

25. Nibali L, Sun C, Akcalı A, Yeh YC, Tu YK, Donos N. The effect of horizontal and vertical furcation involvement on molar survival: A retrospective study. J Clin Periodontol. 2018;45(3):373-381. doi: 10.1111/jcpe.12850. Epub 2018 Jan 19. PMID: 29219193.

26. Graetz C, Plaumann A, Wiebe JF, Springer C, Sälzer S, Dörfer CE. Periodontal probing versus radiographs for the diagnosis of furcation involvement. J Periodontol. 2014;85(10):1371-9. doi: 10.1902/jop.2014.130612. Epub 2014 Mar 7. PMID: 24605872.

27. Yusof NAM, Erni Noor E & Yusof MYPM. The accuracy of linear measurements in cone beam computed tomography for assessing intrabony and furcation defects: A systematic review and meta-analysis. J Oral Res 8(6):527-539. doi:10.17126/joralres.2019.077

28. Yusof NAM, Noor E, Reduwan NH, Yusof MYPM. Diagnostic accuracy of periapical radiograph, cone beam computed tomography, and intrasurgical linear measurement techniques for assessing furcation defects: a longitudinal randomised controlled trial. Clin Oral Investig. 2021;25(3):923-932. doi: 10.1007/s00784-020-03380-8. Epub 2020 Jun 14. PMID: 32535703
Published
2024-06-05
How to Cite
MOHAMED YUSOF, Nurul Ain; MOHD SUAN, Mohd Azri; YAHAYA, Rusmizan. Effects of furcation involvement on molar survival in periodontally treated patients. Journal of Oral Research, [S.l.], v. 13, n. 1, p. 101-111, june 2024. ISSN 0719-2460. Available at: <https://www.joralres.com/index.php/JOralRes/article/view/joralres.2024.009>. Date accessed: 14 oct. 2024. doi: https://doi.org/10.17126/joralres.2024.009.