44 |
SANZ et al .
R3.15 | What is the adequate management of maxillary Class III furcation involvement? Evidence-based recommendation (3.15) In maxillary Class III and multiple Class II furcation involvement in the same tooth nonsurgical instrumentation, OFD, tunneling, root separation or root resection may be considered . Supporting literature Dommisch et al. (2020) Quality of evidence Six observational studies (633 patients) with low quality of evidence. Grade of recommendation Grade 0—↔ Strength of consensus Strong consensus (0% of the group abstained due to potential CoI)
cost for retaining periodontally compromised molars were minimal (Schwendicke et al., 2016).
Patient preferences There is a strong patient preference for tooth retention (IQWiG, 2016). Applicability The guideline can be applied since it is independent of availability of materials and a segment of the dental workforce has been trained or can be trained to deliver resective treatment in the different European health systems. R3.16 | What is the adequate management of mandibular Class III furcation involvement? Evidence-based recommendation (3.16) In mandibular Class III and multiple Class II furcation involvement in the same tooth nonsurgical instrumentation, OFD, tunneling, root separation or root resection may be considered . Supporting literature Dommisch et al. (2020) Quality of evidence Seven observational studies (665 patients) with low quality of evidence. Grade of recommendation Grade 0—↔ Strength of consensus Unanimous consensus (0% of the group abstained due to potential CoI)
Background
Intervention See previous sections.
Available evidence Six observational studies with 633 patients.
Risk of bias Low quality of evidence for observational studies.
Consistency Following treatment of maxillary Class III furcation involvement, moderate to substantial heterogeneity in the size of the effect (wide ranges of tooth survival) was observed. The reasons cannot be de - termined from the existing data. Clinical relevance and effect size Following treatment of maxillary Class III furcation involvement, rea - sonable survival rates were observed over 4–30.8 years. Balance of benefit and harm We did not identify data about harm directly related to procedures. Regarding tooth survival, a benefit of root amputation/resection, root separation or tunnelling compared to SRP or OFD cannot be currently stated. For the individual choice of procedure, however, the clinician should consider criteria beyond class of furcation in - volvement (e.g. bone loss, jaw). Economic considerations Simulations based on the German health system have indicated that tooth retention after complex periodontal therapy of teeth with furcation involvement is more cost-effective than their ex - traction and replacement with an implant supported fixed partial denture (Schwendicke et al., 2014). A study assessing the actual cost of retention of molars in the same health system showed that
Background
Intervention See previous sections.
Available evidence Seven observational studies with 665 patients (with mandibular class III furcation).
Risk of bias Low quality of evidence for observational studies.
Consistency Following treatment mandibular Class III furcation involvement, moderate to substantial heterogeneity in the size of the effect (wide ranges of tooth survival) was observed. The reasons cannot be de - termined from the existing data. Clinical relevance and effect size Following treatment of mandibular Class III furcation involvement, reasonable survival rates were observed over 4–30.8 years.
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