Resective surgery for the treatment of furcation involvement: A systematic review

J Clin Periodontol. 2020 Jul:47 Suppl 22:375-391. doi: 10.1111/jcpe.13241.

Abstract

Objective: To evaluate the benefit of resective surgical periodontal therapy (root amputation or resection, root separation, tunnelling) in periodontitis patients exhibiting class II and III furcation involvement (FI) compared with non-surgical treatment (SRP) or open flap debridement (OFD).

Material: Outcomes were tooth survival (primary), vertical probing attachment gain, and reduction in probing pocket depth (secondary) evidenced by randomized clinical trials, prospective and retrospective cohort studies and case series with ≥ 12 months of follow-up. Search was performed on 3 electronic databases from January 1998 to December 2018.

Results: From a total of 683 articles, 66 studies were identified for full-text analysis and 7 studies finally included. Six hundred sixty-seven patients contributed 2,021 teeth with class II or III FI. Data were very heterogeneous regarding follow-up and distribution of FI. A total of 1,515 teeth survived 4 to 30.8 years after therapy. Survival ranged from 38%-94.4% (root amputation or resection, root separation), 62%-67% (tunnelling), 63%-85% (OFD) and 68%-80% (SRP). Overall, treatment provided better results for class II FI than class III.

Conclusion: Within their limits, the data indicate that in class II and III FI, SRP and OFD may result in similar survival rates as root amputation/resection, root separation or tunnelling.

Keywords: furcation involvement; long-term survival; periodontitis; resective surgery.

Publication types

  • Systematic Review

MeSH terms

  • Furcation Defects* / surgery
  • Guided Tissue Regeneration, Periodontal
  • Humans
  • Periodontitis* / surgery
  • Prospective Studies
  • Retrospective Studies