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

BackgroundThe aim of this study was to investigate risk of tooth loss in molars with furcation involvement (FI) based on initial diagnosis. Materials and MethodsA systematic search of the literature was conducted in Ovid Medline, Embase, LILACS and Cochrane Library for longitudinal studies with at least 3years follow-up including measures of FI and data on tooth loss. ResultsA total of 21 studies were included in the review, from an initial search of 1207 titles. The relative risk of tooth loss during maintenance therapy attributable to FI was 1.46 (95% CI=0.99-2.15, p=0.06) for studies up to 10years and 2.21 (95% CI=1.79-2.74, p<0.0001) for studies with a follow-up of 10-15years. A gradual increase in the risk of tooth loss was observed for molars with degree II and III FI. ConclusionsThe presence of FI approximately doubles the risk of tooth loss for molars maintained in supportive periodontal therapy for up to 10-15years. 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.