title: Tooth loss in molars with and without furcation involvement - a systematic review and meta-analysis.
abstract: BACKGROUND
  The aim of this study was to investigate risk of tooth loss in molars with furcation involvement (FI) based on initial diagnosis.
  
  
  METHODS
  A systematic search of the literature was conducted in Ovid Medline, Embase, LILACS and Cochrane Library for longitudinal studies with at least 3 years follow-up including measures of FI and data on tooth loss.
  
  
  RESULTS
  A 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 10 years and 2.21 (95% CI = 1.79-2.74, p < 0.0001) for studies with a follow-up of 10-15 years. A gradual increase in the risk of tooth loss was observed for molars with degree II and III FI.
  
  
  CONCLUSIONS
  The presence of FI approximately doubles the risk of tooth loss for molars maintained in supportive periodontal therapy for up to 10-15 years. 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.
authors.affiliation: Periodontology Unit and Department of Clinical Research, UCL Eastman Dental Institute, London, UK.|Clinical Oral Research Centre, Institute of Dentistry, Queen Mary University London (QMUL), London, UK.
authors.forename: Luigi
authors.initials: L
authors.lastname: Nibali
authors.affiliation: Periodontology Unit and Department of Clinical Research, UCL Eastman Dental Institute, London, UK.
authors.forename: Angelo
authors.initials: A
authors.lastname: Zavattini
authors.affiliation: Periodontology Unit and Department of Clinical Research, UCL Eastman Dental Institute, London, UK.|Department of Biomaterials Science and Turku Clinical Biomaterials Centre - TCBC, Institute of Dentistry, University of Turku, Turku, Finland.|Department of Removable Partial Prosthodontics Rehabilitation, Tokyo Medical and Dental University, Tokyo, Japan.
authors.forename: Kohji
authors.initials: K
authors.lastname: Nagata
authors.affiliation: Library Services, UCL Eastman Dental Institute, London, UK.
authors.forename: Anna
authors.initials: A
authors.lastname: Di Iorio
authors.affiliation: Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA.
authors.forename: Guo-Hao
authors.initials: GH
authors.lastname: Lin
authors.affiliation: Periodontology Unit and Department of Clinical Research, UCL Eastman Dental Institute, London, UK.
authors.forename: Ian
authors.initials: I
authors.lastname: Needleman
authors.affiliation: Clinical Oral Research Centre, Institute of Dentistry, Queen Mary University London (QMUL), London, UK.
authors.forename: Nikos
authors.initials: N
authors.lastname: Donos
mesh_terms: D005260:Female; D017823:Furcation Defects / Q000628:therapy; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008963:Molar; D016388:Tooth Loss
keywords: furcation; progression; tooth loss; treatment