Long-Term Prognosis of Teeth With Class II Furcation Involvement: A Retrospective Cohort Study

J Clin Periodontol. 2025 Sep;52(9):1298-1305. doi: 10.1111/jcpe.14186. Epub 2025 Jun 2.

Abstract

Objective: To evaluate the survival of teeth with class II furcation involvement (FI) ≥ 5 years after active periodontal treatment (APT) and to identify the prognostic factors.

Methods: All charts of patients having undergone APT at the Department of Periodontology of Goethe-University Frankfurt, Germany, were screened for teeth with class II FI. APT had to be accomplished ≥ 5 years ago. Charts were analysed for data of class II FI teeth at baseline (T0), after APT (T1) and at the last supportive periodontal care (SPC/T2).

Results: Two-hundred and twenty-two patients (age: 56.5 ± 10.1 years; 118 females; 35 active smokers; 17 diabetics, 154 stage III, 68 stage IV, 94 grade B, 128 grade C) presented 543 teeth with class II FI. Sixty-one patients lost 93 teeth (17%), on average, over 108.4 ± 36.5 months of SPC. Logistic/Cox proportional hazards mixed-model regressions associated increased tooth loss with irregular SPC (p = 0.023/0.073), premolar versus molar (p = 0.041/0.017), root canal filling (RCF) (p < 0.001) and multiple class II FI per tooth at T1 (p = 0.001/0.024).

Conclusions: Of a total of 543 teeth with class II FI, 83% were retained for 108.6 ± 36.5 months. Multiple class II FI at T1, RCF, premolars and irregular SPC were found to compromise the long-term prognosis of teeth with class II FI.

Keywords: furcation involvement degree II; periodontal treatment; periodontitis stage III and IV.

MeSH terms

  • Adult
  • Aged
  • Bicuspid / pathology
  • Cohort Studies
  • Female
  • Follow-Up Studies
  • Furcation Defects* / classification
  • Furcation Defects* / complications
  • Furcation Defects* / therapy
  • Humans
  • Male
  • Middle Aged
  • Molar / pathology
  • Prognosis
  • Retrospective Studies
  • Root Canal Therapy / statistics & numerical data
  • Smoking
  • Tooth Loss / classification
  • Tooth Loss / etiology