ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title Non-Surgical Periodontal Therapy Is As Effective As Surgical Periodontal Therapy In Treating Patients With Furcation Involvements
Clinical Question In a middle aged patient with mild furcation on multi-rooted teeth, does periodontal surgery treatment improve the longevity of teeth better than scaling and root planing?
Clinical Bottom Line Non-surgical conservative therapy is as effective as surgical periodontal therapy in preventing loss of furcation-involved teeth. (See Comments on the CAT below)
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 19207893Hyyn-Ba/ 2009Patients with furcation involvementSystemic review of prospective and retrospective cohort studies
Key resultsThe survival rate of molars treated non-surgically was >90% after 5-9 years. The corresponding values for the different surgical procedures were: 1) Surgical therapy- 43.1%-96%, observation period: 5-53 years 2) Tunneling procedures: 42.9%-92.9%, observation period: 5-8 years 3) Surgical resective procedures including amputation(s) and hemi-sections: 62%-100%, observation period: 5-13 years 4) Guided tissue regeneration (GTR): 83.3%-100%, observation period: 5-12 years. The most frequent complications included caries in the frucation area after tunneling procedures and root fractures after root-resective procedures.
Evidence Search #5 Search surgical periodontal treatment #4 Search surgical treatment #3 Search non-surgical periodontal treatment 14:27:51 551#2 Search non-surgical periodontal 14:27:43 554#1 Search furcation 14:27:01 1221
Comments on
The Evidence
The Huynh-Ba article reported a systematic review of various treatments for furcation involvement on multi-rooted teeth, including 22 trials, comparing non-surgical periodontal treatment to several different types of surgical treatment. The author reported a comprehensive, detailed search for relevant trials and assessed the individual studies for validity using clear criteria, and found the evidence to be of high quality. No meta-analysis was done.
Applicability Subjects were representative of patients that have furcation involvement on multi-rooted teeth. The benefits patients could potentially experience are improvement in the longevity of furcation-involved teeth with both non-surgical conservative therapy and surgical periodontal therapy. However, other outcomes could be complications including recurrence of periodontitis, periodontal abscesses, combined endodontic-periodontal lesions, caries, and root fractures.
Specialty/Discipline (Endodontics) (General Dentistry)
Keywords Furcation, non-surgical periodontal treatment, surgical periodontal treatment, survival
ID# 760
Date of submission: 04/28/2011spacer
E-mail Leen3@livemail.uthscsa.edu
Author Namhee Lee
Co-author(s)
Co-author(s) e-mail
Faculty mentor/Co-author Cristina Villar, DDS
Faculty mentor/Co-author e-mail Villar@uthscsa.edu
Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?)
post a rationale
None available
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Comments on the CAT
(FOR PRACTICING DENTISTS' and/or FACULTY COMMENTS ON PUBLISHED CATs)
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by David Faltys, Harrison Luke & Marissa Stewart (San Antonio, TX) on 01/06/2014
A systematic review done by Needleman in 2010 ( 20577278 ) further supported the conclusions reached in this CAT. This review analyzed twenty-two publications and found that the survival rate for non-surgically treated molars with furcation involvement was >90%. Nonsurgical mechanical debridement is a successful treatment for initial furcation involvement and it avoids the complications associated with resective surgeries.
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