Prognosis of Furcation Involved Teeth: Cost-Effectiveness over Implant Placement

The severe intrusion of dental implants in everyday clinical practice tends to replace conservative therapeutic approaches of maintaining teeth with dubious prognosis. Furcation-involved (FI) molars pose a great dilemma to the clinician, as in most cases their treatment requires significant effort using surgical interventions as well. Prognosis for multi-rooted is usually worse than single-rooted teeth and additionally, furcation degree III is associated with significantly increased rates of tooth loss. However, clinical studies have shown that retention of teeth with poor prognosis have little effect on the proximal bone loss around adjacent teeth and possibly can be maintained over 10 years in patients who receive regular supportive periodontal treatment. The decision to retain furcation involved teeth is complex and based on multiple aspects such as the extent of dental caries, the remaining tooth structure, the extent of previous reconstructions, post and core build-ups, the extent of periodontal destruction, and the risks associated with endodontic therapy. On the other hand, implant therapy is not panacea. Implants which have been place in periodontal patients are possible to develop peri-implantitis after 5 years of function, with multiple factors to be asociated with the prevalence of disease. The purpose of the current review is to determine the cost-effectiveness of furcation involved molars replacement with dental implants. Many studies, which have been carried out recent years, indicated that maintenance of a furcated-molar with severe bone loss and the patient’s obliance to the supportive periodontal treatment is of paramount importance in order to establish their retention in patient’s dentition. Recent studies have been shown that maintenance of molars with FI is less costly than their replacement with implants and the treatment they might later require, regardless patient’s risk profile. When periimplantitis occurs, initial and follow-up therapies generate further and high costs. Therefore, dentists should reconsider the benefits regarding effortless extractions and implant replacements and measures in order to preserve the permanent dentition.