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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) 19207893 | Hyyn-Ba/ 2009 | Patients with furcation involvement | Systemic review of prospective and retrospective cohort studies | | Key results | The 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 treatment14:27:51551#2 Search non-surgical periodontal 14:27:43554#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) (Dental Hygiene) |
| Keywords |
Furcation, non-surgical periodontal treatment, surgical periodontal treatment, survival
|
| ID# |
760 |
| Date of submission: |
04/28/2011 |
| 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 | |
|
Comments and Evidence-Based Updates on the CAT
(FOR PRACTICING DENTISTS', FACULTY, RESIDENTS and/or STUDENTS COMMENTS ON PUBLISHED CATs) |
post a comment |
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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