Radiographic parameters as prognostic indicators for healing of class II furcation defects.
OBJECTIVE
To evaluate radiographic measurements for use as prognostic indicators for healing of class II furcation defects following regenerative therapy.


METHODS
In 17 patients (eight females), 33 class II furcation defects (mandibular buccal (n=10) and lingual (n=12), and maxillary buccal (n=11)) were treated using the barrier membrane technique. Twenty-six furcations were treated using a bioabsorbable membrane, while a nonresorbable membrane was used to treat the remaining seven furcation defects. Clinical parameters and standardized radiographs were obtained before as well as 6 and 24 months after therapy. All radiographs were digitized and evaluated by an examiner blinded to the clinical data. The following distances were measured: cemento-enamel junction line (CEJ-line) to alveolar crest (AC) at the furcation site (AC-CEJ line), CEJ-line to the furcation fornix (Fx-CEJ line), width of the furcation at the level of the AC (FW) as well as the distance from Fx to a straight line between the AC mesial and distal of the tooth (Fx-AC line).


RESULTS
Statistically significant (p<0.001) horizontal attachment gains could be observed 6 and 24 months after therapy (6 months: 1.49+/-0.85 mm; 24 months: 1.14+/-0.91 mm). However, a small but statistically significant (p=0.031) attachment loss of 0.35 mm was observed between the 6 and 24 months examination. Multilevel regression analyses identified baseline probing depth (p=0.0017) and 3 of the radiographic distances as prognostic factors: Fx-CEJ line (p=0.014), FW (p=0.0535), Fx-AC line (p=0.0827).


CONCLUSIONS
The analysis of presurgical radiographs may yield information on the success of the regenerative therapy of buccal and lingual class II furcation defects. A long root trunk, a wide furcation entrance and an Fx coronal to the AC have negative influences on the success of therapy. Further, a deep probing depth at the furcation site at baseline increases the likelihood for more favourable horizontal attachment gain in furcations.
Horwitz
Jacob
J
Periodontal Unit, Department of Maxillofacial Surgery, Rambam Medical Center, Haifa 31096, Israel.
Machtei
Eli E
EE
Reitmeir
Peter
P
Holle
Rolf
R
Kim
Ti-Sun
TS
Eickholz
Peter
P
D020341:Absorbable Implants; D000328:Adult; D000539:Alveolar Process / Q000000981:diagnostic imaging; D005260:Female; D005500:Follow-Up Studies; D017823:Furcation Defects / Q000145:classification / Q000000981:diagnostic imaging* / Q000601:surgery; D016557:Guided Tissue Regeneration, Periodontal / Q000295:instrumentation; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D008336:Mandibular Diseases / Q000601:surgery; D008439:Maxillary Diseases / Q000601:surgery; D008567:Membranes, Artificial; D008875:Middle Aged; D017622:Periodontal Attachment Loss / Q000601:surgery; D010514:Periodontal Pocket / Q000601:surgery; D011379:Prognosis; D011859:Radiography; D012044:Regression Analysis; D016037:Single-Blind Method; D019237:Tooth Cervix / Q000000981:diagnostic imaging; D014092:Tooth Root / Q000000981:diagnostic imaging; D014945:Wound Healing
D008567:Membranes, Artificial