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J Am Dent Assoc, Vol 140, No 4, 434-440.
© 2009 American Dental Association

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CLINICAL PRACTICE

Radiographic Characteristics of Furcation Involvements in Mandibular Molars as Prognostic Indicators of Healing After Nonsurgical Periodontal Therapy



Hugo Felipe Do Vale, DDS, Érica Del Peloso Ribeiro, PhD, Sandro Bittencourt, PhD, Francisco H. Nociti Jr., MS, PhD, Enilson A. Sallum, MS, PhD and Márcio Zaffalon Casati, MS, PhD

Background. The authors conducted a study to evaluate the radiographic characteristics of Class II mandibular furcation involvements as prognostic indicators of healing after nonsurgical periodontal therapy.

Methods. Twenty-three patients with chronic periodontitis (Class II furcation involvements in mandibular molars, probing pocket depth [PPD] of 5 millimeters or greater and bleeding on probing [BOP]) were selected to receive nonsurgical periodontal treatment. The authors evaluated visible plaque index, BOP, position of the gingival margin, PPD, relative attachment level (RAL) and relative horizontal attachment level. On radiographs, the authors measured root trunk, bone attachment level in the furcation region, lesion height (Lh), furcation width at alveolar crest level inside furcation (Fw) and 2 mm apical to the fornix (Fw2), and the perpendicular distance from the horizontal line connecting mesial and distal radiographic alveolar crest to furcation fornix. They analyzed all data using linear multiple regression.

Results. Six months after treatment, the furcations showed a mean RAL gain of 1.08 mm (± 1.25 mm) and a PPD decrease of 2.74 mm (± 1.58 mm). The authors found a statistically significant influence between Fw and PPD (P = .0044), Fw2 and PPD (P = .0014), Lh and PPD (P = .0241), and Fw2 and RAL (P = .0037).

Conclusions. Within the limitations of this study, the results suggest that Fw, Fw2 and Lh may influence the response of Class II mandibular furcations to nonsurgical periodontal therapy and may serve as prognostic indicators for this therapy. Thus, narrower and shorter root furcations would be expected to have better outcomes.

Key Words: Periodontal disease; furcation defects; dental radiography

Abbreviations: BOP: Bleeding on probing. • CEJ: Cementoenamel junction. • Fw: Furcation width at alveolar crest level inside furcation. • Fw2: Furcation width 2 millimeters apical to the fornix. • Fx: Furcation fornix. • Lh: Lesion height. • PGM: Position of the gingival margin. • PPD: Probing pocket depth. • RAL: Relative attachment level. • RHAL: Relative horizontal attachment level.







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