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Objectives: To identify the ocuurrence, distribution, and factors associated with lost molars and furcation defects in a sample of the Bulgarian population., Material and Methods: The full mouth cone-beam computed tomography of 56 male and 57 female patients, aged between 19 and 84 years, were examined. A comprehensive evaluation was performed on a total of 675 molars-339 in maxilla and 336 in mandible. Associations with variables such as age, gender, and periodontal disease were analyzed., Results: With aging the number of missing teeth and interradicular lesions increased. No significant links between gender and molar loss (p = .64) or gender and furcation involvement (p = .25) was found. Periodontitis was strongly associated with both studied dental problems (p < .001). The occurrence of furcation defects was more frequently observed in the maxilla than in the mandible., Conclusion: The occurrence and distribution of lost molars and furcation defects is substantial within the studied sample. Further investigation with a larger patient cohort is needed. Pertinent healthcare strategies to address the observed dental health issues also have to be developed., (© 2024 The Authors. Clinical and Experimental Dental Research published by John Wiley & Sons Ltd.)

Aim: This registry-based retrospective cohort study aimed to evaluate the impact of furcation status on the risk for molar loss., Materials and Methods: Subjects with and without furcation involvement (FI) in 2010/2011 were identified in a nationwide registry in Sweden (age- and gender-matched sample: 381,450 subjects; 2,374,883 molars). Data on dental and periodontal status were extracted for the subsequent 10-year period. Impact of FI (at baseline or detected during follow-up) on molar loss (i.e., tooth extraction) was evaluated through multilevel logistic regression and survival analyses., Results: FI had a significant impact on molar loss. FI degrees 2 and 3 resulted in adjusted risk ratios of 1.67 (95% confidence interval [CI] 1.63-1.71) and 3.30 (95% CI 3.18-3.43), respectively. Following the first detection of deep FI (degrees 2-3), estimated survival decreased by 4% at 5 years and 8% at 10 years. In addition to FI, endodontic status and probing depth were relevant risk factors for molar loss., Conclusions: Furcation status had a clinically relevant impact on the risk for molar loss. Following first detection of deep FI, however, the decline in molar survival was minor., (© 2022 The Authors. Journal of Clinical Periodontology published by John Wiley & Sons Ltd.)

Aim: We aimed to assess the association between furcation involvement (FI) and tooth loss for subjects not undergoing regular periodontal treatment., Materials and Methods: Data from 2333 subjects participating in the baseline and 11-year follow-up of the Study of Health in Pomerania (SHIP) were used. All subjects had half-mouth periodontal examinations, including FI in one upper and one lower molar, at baseline. A total of 1897 subjects and 3267 molars were included in the final analysis., Results: In total, 375 subjects (19.8%) lost molars during the follow-up period. Respectively, 5.6%, 12.7%, 34.0% and 55.6% of molars without FI, degree I FI, degree II FI and degree III FI were lost. Initial probing pocket depth (PPD) and clinical attachment level (CAL) were associated with molar loss (p < .001). Baseline degree I FI was associated with a 1.73 IRR (incidence rate ratio) (95% CI=1.34-2.23, p < .001) of tooth loss while degree II-III was associated with a 3.88 IRR (95% CI=2.94-5.11, p < .001) of tooth loss compared to molars without FI at baseline., Conclusion: This study provides evidence for an increased risk of molar loss affected by periodontal furcation involvement in a general population not undergoing regular periodontal care., (© 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Aim: There is a paucity of up-to-date data regarding prevalence and risk indicators of periodontitis in Italy. Therefore, the aim of this study was to evaluate the prevalence of periodontitis and its risk indicators among adults from an urban area in North Italy., Material and Methods: This cross-sectional survey used a stratified two-stage probability sampling method to draw a representative sample of the adult population of the city of Turin. About 1600 individuals, 20-75 years old, were randomly selected and 736 subjects agreed to participate (47% of the sampled subjects). Clinical parameters were assessed using a full-mouth protocol. Logistic models were applied to assess associations between periodontitis and its putative risk indicators. Age was included as restricted cubic spline., Results: Based on CDC/AAP case definition, the prevalence estimates of severe and moderate periodontitis were 34.94% (95% CI: 31.23-38.74) and 40.78% (95% CI: 36.89-44.79). The probability of periodontitis increased in smokers (adjusted OR 2.06, 95% IC: 1.26-3.37, p = 0.004) and with age but leveled off in the 50+ year-old group (p < 0.001)., Conclusion: Periodontitis was highly prevalent in the Turin population. The present data will enable development of appropriate public health programs and allocation of resources., (© 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Background: Due to the increasing number of older people, there is a need for studies focused on this population. The aims of the present study are to assess oral and systemic conditions in individuals aged 60 to 95 years with access to dental insurance., Methods: Probing depths (PDs), tooth loss, alveolar bone levels, and systemic health were studied among a representative cohort of older individuals., Results: A total of 1,147 individuals in young-old (aged 60 or 67 years), old (aged 72 or 78 years), and old-old (aged ≥81 years) age groups were enrolled, including 200 individuals who were edentulous, in this study. Annual dental care was received by 82% of dentate individuals. Systemic diseases were common (diabetes: 5.8%; cardiovascular diseases: 20.7%; obesity: 71.2%; elevated C-reactive protein [CRP]: 98.4%). Serum CRP values were unrelated to periodontal conditions. Rates of periodontitis, defined as ≥30% of sites with a distance from cemento-enamel junction to bone of ≥5 mm, were 11.2% in women in the young-old age group and 44.9% in men in the old-old age group. Individuals in older age groups had a higher likelihood of periodontitis defined by bone loss and cutoff levels of PD ≥5 mm (odds ratio: 1.8; 95% confidence interval: 1.2 to 2.5; P <0.01). A total of 7% of individuals in the old-old age group had ≥20 teeth and no periodontitis. Systemic diseases, dental use, or smoking were not explanatory, whereas age and sex were explanatory for periodontitis., Conclusions: The prevalence of periodontitis increased with age. Sex seems to be the dominant explanatory factor for periodontitis in older individuals. Despite frequent dental visits, overall oral health in the oldest age cohort was poor.

Unlabelled: The aim was to study the prevalence and distribution of number of teeth, number of intact and decayed teeth and prevalence and distribution of removable dentures and periodontal disease over 25 years 1983-2008. Two cross-sectional studies (EpiWux) were performed in the County of Dalarna, Sweden in 1983 and 2008. In the 1983 study a random sample of 1012 individuals were invited to participate in this epidemiological and clinical study and 1440 individuals in 2008. A total number of 1695 individuals, stratified into geographical areas (rural and urban areas), in the age groups 35, 50, 65 and 75 answered a questionnaire and were also clinically and radiographically examined.The number of edentulous individuals decreased from 15% in 1983 to 3% in 2008. Number of teeth increased from 22.7 in 1983 to 24.2 in 2008 and decayed surfaces per tooth showed a three-time reduction over this period of time. As a consequence of better oral status the prevalence of complete removable dentures in both jaws decreased from 15% in 1983 to 2% in 2008. Individuals with moderate periodontitis decreased from 45% in 1983 to 16% in 2008., Conclusion: Covering a period of 25 years the present study can report dramatic improvements in all aspects of dental status that were investigated.This is encouraging for dental care professionals, but will not necessarily lead to less demand for dental care in the future as the population is aging with a substantial increase in number of teeth.

Introduction: This study was undertaken after a personal clinical observation (by AV) that periodontal disease and subsequent attachment loss in the molar root bi-furcation occurs more frequently on the buccal than the lingual aspect of mandibular permanent molars, particularly the first molar., Aims: The purpose of this investigation was to determine the prevalence and severity of furcation defects on the buccal and lingual aspects of mandibular first molars visually and photographically., Materials and Methods: One hundred and six dried human mandibles with neither caries nor restorations on the second premolar or first and second molars were the study sample. Presence and severity of the furcation defects and the position of the mandibular first molar in the mandibular arch were recorded visually. The mandibles were then photographed using a standardized method and the same observations made and compared with those of the visual recording., Results: There were more furcation defects on the buccal than the lingual aspects. Most first molars were within the arch, followed by buccal then lingual. The lowest prevalence, and severity, of furcation defects was when the first molar was within the mandibular arch., Conclusions: Mandibular first molar furcation prevalence and severity on the lingual was lower than on the buccal aspect, particularly when the first molar was within the arch suggesting that an "anatomically normal" position of the mandibular first molar may have a protective effect. Another observation was that standardized photographs of the mandible may be used for measurements and provides a convenient data base for research.

The aim of the present study was to investigate the prevalence and severity of alveolar bone loss and angular bony defects in randomly selected panoramic radiographs. A total of 500 panoramic radiographs of adult patients seeking dental care were studied. The mean age of the subjects was 51 years (range 20-80). The assessments of alveolar bone levels and angular bony defects were performed by direct measurements of the distance between the cemento-enamel junction (CEJ) and bone level. The results demonstrated a gradual and significant increase in the frequency of bone loss with increasing age (p<0.05). Angular bony defects were found in 249 subjects (49.8 %) and were most frequent at the mandibular first molar. The mean depth of the angular bony defects was 6.0 mm with the greatest mean depth in the maxillary anterior area (6.8 mm). The mean mesiodistal depth of the intrabony defects was 2.44 mm, most pronounced in maxillary molars (3.1 mm). In conclusion, the study demonstrated a high prevalence of angular bony defects suitable for regenerative periodontal treatment.

Background: There is increasing evidence that chronic infections, such as periodontal diseases, could play a role in the initiation and development of coronary artery disease (CAD). The present study was intended to test for a possible association between presence and severity of periodontitis and coronary artery disease in a Belgian population., Methods: A total of 108 CAD patients (mean age 59.2 +/- 11 years) and 62 presumably healthy controls (mean age 57.7 +/- 9 years) were enrolled in the study. Probing depth, periodontal pocket bleeding index (PPBI), plaque index, furcation involvements, and tooth mobility were evaluated to compare periodontal health in both groups. The subjects were also ranked according to a novel index of periodontitis severity, the periodontal index for risk of infectiousness (PIRI), aimed at quantifying the risk of release of proinflammatory mediators from the periodontal sites., Results: Periodontitis was significantly more frequent in CAD patients than in controls (CAD patients: 91%; controls: 66%). The mean number of pockets was 18 +/- 17.1 in cardiac patients versus 7.6 +/- 12.7 in controls (P < 0.0001), despite the fact that the mean number of missing teeth was significantly greater in cases than in controls (14 +/- 7.1 versus 9 +/- 5.2; P < 0.0001). Furthermore, proportions of mobile teeth, bleeding sites, periodontal pockets, and involved furcations were significantly higher in CAD patients than in controls. In addition, the extent of the periodontal disease present was also greater in cases than in controls. A logistic model, adjusted for known cardiovascular risk factors, showed a strong association between CAD and periodontitis (odds ratio [OR] = 6.5). Moreover, there was a significant dose-response relationship between increasing scores of the periodontal risk of infectiousness and the presence of CAD (adjusted OR = 1.3 per PIRI unit)., Conclusion: In the present study, periodontitis was revealed to be a significant risk factor for CAD after adjusting for other confounding factors, with the level of association increasing with the individual extent of the periodontal lesions.

Background: Accurate information on the prevalence and extent of periodontal diseases in the United States adult population is lacking. This study estimated the prevalence and extent of periodontal disease in the United States using data from the third National Health and Nutrition Examination Survey (NHANES III)., Methods: A nationally representative sample was obtained during 1988 to 1994 by a stratified, multi-stage probability sampling design. A subsample of 9,689 dentate persons 30 to 90 years old who received a periodontal examination was used in this study, representing approximately 105.8 million civilian, non-institutionalized Americans in 1988 to 1994. Periodontal attachment loss, probing depth, and furcation involvement were assessed in 2 randomly selected quadrants per person. Attachment loss and probing depth were assessed at 2 sites per tooth, the mesiobuccal and mid-buccal surfaces. The periodontal status of each subject was assessed by criteria based on the extent and severity of probing depth and furcation involvement. These assessments were used to classify each subject as having a mild, moderate, or advanced form of the disease. In the analyses, weighted data were used to reflect the complex sampling method., Results: Prevalence of attachment loss > or = 3 mm was 53.1% for the population of dentate U.S. adults 30 to 90 years of age and, on average, 19.6% of teeth per person were affected. The prevalence of probing depth > or = 3 mm was 63.9% and, on average, 19.6% of teeth were affected. Fourteen percent of these persons had furcation involvement in one or more teeth. We estimate that at least 35% of the dentate U.S. adults aged 30 to 90 have periodontitis, with 21.8% having a mild form and 12.6% having a moderate or severe form. The prevalence and extent of attachment loss and the prevalence of periodontitis increase considerably with age. However, the prevalence of moderate and advanced periodontitis decreases in adults 80 years of age and older. This is most likely attributed to a combination of a high prevalence of tooth loss and gingival recession in the oldest age cohorts. Attachment loss and destructive periodontitis were consistently more prevalent in males than females, and more prevalent in blacks and Mexican Americans than whites. We estimate that in persons 30 years and older, there are approximately 56.2 and 67.6 million persons who, on average, have about a third of their remaining teeth affected by > or = 3 mm attachment loss and probing depth, respectively. We also estimate that about 21 million persons have at least one site with > or = 5 mm attachment loss, and 35.7 million persons have periodontitis. These are conservative estimates based on partial-mouth examinations, and the true prevalence and extent of periodontal disease may be significantly higher than what is reported here., Conclusions: Periodontitis is prevalent in the U.S. adult population. The results show that black and Mexican American males have poorer periodontal health than the rest of the U.S. adult population. Primary and secondary preventive measures should therefore be specifically targeted towards these groups.

The aim of this study was to compare changes in periodontal status in a Swedish population over a period of 20 years. Cross-sectional studies were carried out in Jönköping County in 1973, 1983, and 1993. Individuals were randomly selected from the following age groups: 20, 30, 40, 50, 60, and 70 years. A total of 600 individuals were examined in 1973, 597 in 1983, and 584 in 1993. The number of dentate individuals was 537 in 1973, 550 in 1983, and 552 in 1993. Based on clinical data and full mouth intra-oral radiographs, all individuals were classified into 5 groups according to the severity of the periodontal disease experience. Individuals were classified as having a healthy periodontium (group 1), gingivitis without signs of alveolar bone loss (group 2), moderate alveolar bone loss not exceeding 1/3 of the normal alveolar bone height (group 3), severe alveolar bone loss ranging between 1/3 and 2/3 of the normal alveolar bone height (group 4), or alveolar bone loss exceeding 2/3 of the normal bone height and angular bony defects and/or furcation defects (group 5). During these 20 years, the number of individuals in groups 1 and 2 increased from 49% in 1973 to 60% in 1993. In addition, there was a decrease in the number of individuals in group 3, the group with moderate periodontal bone loss. Groups 4 and 5 comprised 13% of the population and showed no change in general between 1983 and 1993. The individuals comprising these groups in 1993, however, had more teeth than those who comprised these groups in 1983; on the average, the individuals in disease group 4 had 4 more teeth and those in disease group 5, 2 more teeth per subject. In 1973, these 2 groups were considerably smaller, probably because of wider indications for tooth extractions and fewer possibilities for periodontal care which meant that many of these individuals had become edentulous and were not placed in a group. Individuals in groups 3, 4, and 5 were subdivided according to the number of surfaces (%) with gingivitis and periodontal pockets (> or =4 mm). In 1993, 20%, 42%. and 67% of the individuals in groups 3, 4, and 5 respectively were classified as diseased and in need of periodontal therapy with >20% bleeding sites and >10% sites with periodontal pockets > or =4 mm. In conclusion, an increase in the number of individuals with no marginal bone loss and a decrease in the number of individuals with moderate alveolar bone loss can be seen. The prevalence of individuals in the severe periodontal disease groups (4, 5) was unchanged during the last 10 years; however, the number of teeth per subject increased.

By means of panoramic radiography and additional intraoral radiographs, the occurrence of calculus, the extent of horizontal bone loss, the depth and number of infrabony pockets, the number of furcation lesions, and the number of interproximal restoration overhangs were studied in 169 dentate 76-, 81-, and 86-year-old subjects (54 male and 115 females) living at home. Alveolar bone loss (horizontal or vertical) among the participants was common, and in only 8 subjects (5%) was it judged non-existent. It was slight in 30 subjects (18%), moderate in 53 (31%), and advanced in 78 (46%). Infrabony pockets were found in 51% of the subjects and furcation lesions in 28%. The presence of calculus did not correlate with the other parameters. The number of interproximal overhangs was associated with the number of infrabony pockets and of furcation lesions (R=0.3, p<0.001 and p<0.0001) and the number of infrabony pockets with the number of furcation lesions (R=0.4, p<0.0001). Our study shows that periodontal findings are common in the dentate elderly, and associations recently found between periodontal infections and several serious diseases make radiographic examination an integral part of the oral examination of the elderly patient.

A retrospective study examined the frequency of a feasible or remotely possible indication for regenerative therapy of furcation involvement in a large group of periodontally diseased patients. The judgment about the feasibility of the indication was mainly based on results of current randomized controlled clinical trials with regard to tooth type and location of the furcation lesion. Data from 558 patients treated by two periodontists, one experienced and one in training, were analyzed. Furcation involvement of at least one multirooted tooth was found in 40% and 63% of the two dentists' patients. In only 20% and 27% of their patients was there a potential indication for regenerative furcation treatment. Of 1,134 furcation lesions, 180 (15.9%) were conceivably suitable for this procedure. Only 17 sites with a feasible or remotely possible indication were treated in that way. In most cases, conventional furcational treatment (flap surgery with scaling and root planing) was performed.

The purposes of the present study were to examine the frequency of cervical enamel projection in mandibular molars with class II furcation defects and to examine the response of these teeth to guided tissue regeneration procedures. Probing depth and vertical and horizontal periodontal attachment levels were recorded with a constant-force electronic periodontal probe. Following surgical exposure of the bifurcation and prior to membrane placement, the cervical enamel projection was examined and then graded clinically; photographs were taken to allow further examination of the bifurcation. An overall improvement in clinical parameters was observed in most sites. Cervical enamel projection was present in 82.1% of all molars examined. Grade II was the most prevalent (34.8%). Patients with any degree of cervical enamel projection demonstrated significantly higher mean probing depths at baseline than did patients without cervical enamel projection. Likewise, pretreatment probing attachment levels were higher in patients with some degree of cervical enamel projection. However, greater posttreatment horizontal and vertical attachment gains were observed in sites with a baseline cervical enamel projection.

The aim of this study was to evaluate the prevalence of furcation-involved molars in a patient sample referred for periodontal treatment. A total of 222 patients aged, 14-73 years (mean age 45 years), and with signs of destructive periodontal disease in at least 2 quadrants of the dentition were included in the study. The clinical examination involved assessments of oral hygiene status, gingival conditions, probing pocket depth and presence/degree of furcation involvement. In addition, a full mouth intraoral radiographic examination was performed. The results revealed that 4% of the patients presented with all 12 molars, while 3% had lost all molars. 52% of the individuals had at least 8 molars; 95% of subjects < 30 years of age and 19% in the age 60+ years. In patients aged > or = 40 years, every 2nd molar showed advanced periodontal destruction in the furcation area. The prevalence of furcation involved molars was higher in the maxilla than in the mandible. From the age of 30 years, about 50% of the 1st and 2nd molars in the maxilla showed at least 1 furcation site with deep involvement, while in the mandible a similar prevalence was observed first after the age of 40 years. The highest frequency of furcation involvement was found at the distal site of the maxillary 1st molar (53%), and the mesial aspects of the maxillary 2nd molar showed the lowest frequency (20%). Furcation sites with a probeable trunk region were observed at a frequency of 17-22% at the various tooth sites. It was concluded that tooth morphology may be an important factor that accounts for the variability in prevalence of molar furcation involvement.

The purposes of the study were as follows: (1) to evaluate the molar furcation involvement and number of molar correlated with age and sex; and (2) to study the relationship between the means of alveolar bone loss and associated factors of molar furcation involvements (FIs). 1102 molars (703 males and 399 females) were measured in 219 individuals (136 males and 83 females) for the alveolar bone loss and associated factors of molar furcation involvements. Based on the results, we conclude the following: (1) the higher prevalence of FI was in the mandibular first molar (94.6%), whereas the lowest prevalence of FI was in maxillary second molar; (2) except for the mandibular first molar, the prevalence of molar FI markedly increased with an increased age group (16 & 26, r = 0.335, p < 0.01; 17 & 27, r = 0.345, p < 0.01; 37 & 47, r = 0.239, p < 0.01); (3) the prevalence of molar FI was significantly higher in males than in females (p < 0.05); (4) the mean number of molar FI was significant greater in males (mean = 3.45) than in females (mean = 2.69); (5) factors such as age (r = 0.222, p < 0.01), sex, (r = 0.145, p < 0.05), number of remaining teeth (r = -0.330, p < 0.01) and molar FI (r = 0.471, p < 0.01) are strongly associated with the mean alveolar bone loss of molars.

Thirteen hundred and fifty dogs were examined under anesthesia at veterinary hospitals in the USA and Canada. Periodontal health was recorded in detail. Teeth were frequently absent (particularly lower third molar, upper and lower first premolars, and incisor teeth). Calculus was most extensive on the upper fourth premolar and molar teeth. Missing teeth, mobility of remaining teeth, extent of calculus and gingival inflammation, and furcation exposure and attachment loss all were more common in small dogs compared with larger dogs, and in order dogs compared with younger dogs.