[Conventional surgical furcation therapy. Closed and open scaling]

Area of Science:

• Periodontology
• Epidemiology
• Dental Diagnostics

Context:

• Periodontal disease historically caused significant tooth loss, especially in molars, in individuals over 45.
• Advances in dental awareness and prevention have reduced overall incidence, yet a subset of patients experiences rapid progression and tooth loss.
• Current diagnostic tools fail to identify high-risk patients early.

Purpose:

• To investigate molar loss as an indicator of periodontal risk.
• To explore the potential of early molar furcation involvement diagnosis for identifying high-risk patients.
• To evaluate the effectiveness of different treatment approaches for severe periodontal disease.

Summary:

• Molar loss remains disproportionately high compared to overall tooth loss, even with periodontal treatment.
• Analysis of perio-subgroups suggests molar loss effectively identifies patients with high periodontal risk.
• Successful furcation treatment, despite suboptimal calculus removal, supports this finding.
• Early diagnosis of molar furcation involvement is proposed as a key to identifying patients at risk for severe periodontitis and subsequent molar loss.

Impact:

• Highlights the diagnostic value of molar loss in periodontitis risk assessment.
• Suggests a paradigm shift towards early molar furcation diagnosis for proactive patient management.
• Proposes resective therapy as a potentially more effective treatment for specific cases compared to conventional scaling.