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Impact of Furcation Involvement on Molar Loss
TAKE-HOME MESSAGE
- Using a nationwide registry in Sweden, the authors identified 2.37 million molars in 381,450 participants with and without furcation involvement (FI) between 2010 and 2011 and extracted dental and periodontal status data during the subsequent 10-year period. FI significantly impacted the molar loss, with a greater risk of molar loss when the furcation was deeper. Endodontic status and probing depth were the other risk factors for molar loss.
- FI in the molars is strongly associated with molar loss; however, considering the high long-term survival of these teeth even with FI, extraction should not be considered first.
abstract
This abstract is available on the publisher's site.
Access this abstract nowAIM
This registry-based retrospective cohort study aimed to evaluate the impact of furcation status on the risk for molar loss.
MATERIALS AND METHODS
Subjects with and without furcation involvement (FI) in 2010/2011 were identified in a nationwide registry in Sweden (age- and gender-matched sample: 381,450 subjects; 2,374,883 molars). Data on dental and periodontal status were extracted for the subsequent 10-year period. Impact of FI (at baseline or detected during follow-up) on molar loss (i.e., tooth extraction) was evaluated through multilevel logistic regression and survival analyses.
RESULTS
FI had a significant impact on molar loss. FI degrees 2 and 3 resulted in adjusted risk ratios of 1.67 (95% confidence interval [CI] 1.63-1.71) and 3.30 (95% CI 3.18-3.43), respectively. Following the first detection of deep FI (degrees 2-3), estimated survival decreased by 4% at 5 years and 8% at 10 years. In addition to FI, endodontic status and probing depth were relevant risk factors for molar loss.
CONCLUSIONS
Furcation status had a clinically relevant impact on the risk for molar loss. Following first detection of deep FI, however, the decline in molar survival was minor.
Additional Info
Disclosure statements are available on the authors' profiles:
Furcation involvement and tooth loss: A registry-based retrospective cohort study
J. Clin. Periodontol. 2022 Nov 22;[EPub Ahead of Print], A Trullenque-Eriksson, C Tomasi, M Petzold, T Berglundh, J DerksFrom MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.
This retrospective study evaluated the impact of furcation involvement (FI) on tooth loss based on data from a Swedish national registry. The age- and gender-matched dataset included 381,450 participants with 2,374,883 molars with and without FI at baseline in 2010. Tooth loss over a 7- to 10-year period was assessed. At baseline, 82.7% of molars had no FI, 11.6% had FI 1, 4.7% had FI 2, and only 1.0% had FI 3. The impact of FI at baseline or its detection during the study was evaluated.
Key findings include
Owing to the nature of the study, neither the reason for extraction nor the information regarding the periodontal diagnosis, therapy, and maintenance were included. The potential impact of systemic risk factors, such as smoking and diabetes, could not be evaluated. Multiple practitioners contributed to the dataset, and there was no calibration. Despite these limitations, the outcomes are similar to those reported in other smaller studies, which have evaluated the impact of FI on tooth loss, in that the presence of FI 1 did not significantly impact long-term survival. Even though FI 2 and FI 3 increased the risk of tooth loss, these teeth had 10-year estimated survival rates of approximately 82%. Clinicians should not automatically condemn a tooth with furcation invasion; additional factors that influence prognosis include the probing depth, bone and attachment loss, mobility, molar location, systemic risk factors, restorative and endodontic factors, periodontal intervention, and patient compliance.