The effect of periodontal therapy on the survival rate and incidence of complications of multirooted teeth with furcation involvement after an observation period of at least 5 years: a systematic review

Objective: To systematically review the survival rate and incidence of complications of furcation-involved multirooted teeth following periodontal therapy after at least 5 years.
Material and methods: Electronic and manual searches were performed up to and including January 2008. Publication selection, data extraction and validity assessment were performed independently by three reviewers.
Results: Twenty-two publications met the inclusion criteria. Because of the heterogeneity of the data, a meta-analysis could not be performed. The survival rate of molars treated non-surgically was >90% after 5–9 years. The corresponding values for the different surgical procedures were:
Surgical therapy: 43.1% to 96%, observation period: 5–53 years.
Tunnelling procedures: 42.9% to 92.9%, observation period: 5–8 years.
Surgical resective procedures including amputation(s) and hemisections: 62% to 100%, observation period: 5–13 years.
Guided tissue regeneration (GTR): 83.3% to 100%, observation period: 5–12 years.
The most frequent complications included caries in the furcation area after tunnelling procedures and root fractures after root-resective procedures.
Conclusions: Good long-term survival rates (up to 100%) of multirooted teeth with furcation involvement were obtained following various therapeutic approaches. Initial furcation involvement (Degree I) could be successfully managed by non-surgical mechanical debridement. Vertical root fractures and endodontic failures were the most frequent complications observed following resective procedures.