Changes of Periodontal Conditions of First and Second Molars With Furcation Involvement Grade II or III - a Retrospective Analysis of 14 to 17 Year Follow-up

Abstract

Objective

This retrospective analysis aimed to evaluate the clinical changes and survival rate of first and second molars with furcation involvement (F-Inv) grades II and III after completion of non-surgical active periodontal therapy (APT) and subsequent supportive periodontal therapy (SPT), with a minimum follow-up period of 14 years.

Methods

Retrospective data collection and analysis were conducted on patients with moderate to severe adult periodontitis aged > 35 years, with at least one first or second molar with F-Inv grades II or III. Changes in clinical conditions of the molars with F-Inv were assessed, recording the number and classification of molars with F-Inv, and probing pocket depth (PPD) measurements at six sites per molar. Patient-related variables including % sites with PPD ≤ 5 mm, % bleeding on probing (BOP), tooth loss (TL), smoking status, diabetes, age and duration of SPT were also extracted. Correlations between these patient-related variables and those related with F-Inv molars were calculated.

Results

The analysis included 197 patients with 424 first and second molars with F-Inv grades II and III. At the latest SPT evaluation (T1), 37% of patients achieved an overall PPD ≤ 5 mm. While 66.8% of the molars with F-Inv were retained, a significant number were lost. Mean PPD and percentage of sites with PPD > 5 mm decreased significantly from intake (T0) to T1 for these molars. Overall TL was estimated at an annual rate of 0.21 teeth lost per patient. A higher percentage of sites with PPD > 5 mm at T0 and T1 was correlated with a higher risk of molar loss. Smoking, age, % sites with PPD > 5 mm at T0, and % BOP at T0 correlated with increased TL.

Conclusion

Following non-surgical APT and SPT over a period 14–17 years, 66.8% of the molars with F-Inv grades II and III were effectively maintained. Loss of molars was higher with F-Inv III. Risk factors for molar loss included high % of sites with PPD > 5 mm at T0 and T1. For overall TL Smoking, age, a high percentage of sites with a PPD > 5 mm, and a high BOP percentage were identified as risk factors.