Ocorrência de perda óssea vertical e indicadores de risco associados a defeitos de furca

Abstract

Periodontitis an inflammatory disease causing loss of periodontal attachment. Its progression leads bone loss among roots in the furcation area, causing furcation involvement (FI). These FI frequently occur in individuals with periodontitis, and is more complex the control plaque in teeth with FI. Its progression of attachment loss is faster, the prognosis is worse, and consequently the risk for tooth loss is higher. The FI can be classified according to its vertical bone loss: subclass A, bone loss extending to the coronal third of the root; subclass B, bone loss extending to the middle third of the root; subclass C, bone loss extending to the apical third of the root. Besides etiological and anatomical factors, behavior and demographic factors can be associated with FI occurrence. Thus, This Thesis presents two manuscripts. The first reported the occurrence and severity of vertical radiographic subclassification of furcation defects in the first and second molars and evaluated the risk indicators associated with vertical bone loss in the furcation region. Individuals who participated of the epidemiologic survey, in which an entire clinical periodontal examination and had at least one molar with horizontal FI class II or III (n=167) were included. Some molars did not show visible bone loss in the radiographs, and 85 teeth were subclassified according to vertical bone loss. The results showed that upper molars had a higher occurrence of the more severe (B and C), more associated with a worse prognosis. For vertical bone loss in furcation area, the data were modeled using a multilevel linear regression into two levels (tooth and individual). The results showed that plaque presence, gingival bleeding, probing depth higher than 4mm, former and smokers had a major mean percentage of vertical bone loss into furcation area. The second manuscript described the prevalence, extent and severity of molar furcation involvement and evaluated risk indicators associated with FI occurrence. Individuals (492) who received an entire periodontal examination and had at least one molar (2421 molars) were included. The factors associated with FI were analyzed by multinomial multilevel logistic regression (according to surface, tooth and individual levels). Plaque presence, gingival bleeding, proximal surface, probing depth higher than 4mm, upper first molar, male, individuals older than 55 years old, former and smokers were associated with major chances for FI occurrence.