Comparison of the Tomographic, Clinical Presurgical, and Intrasurgical Assessments of Furcation Involvement in the Lower Molars

This cross-sectional study compared cone-beam computed tomography (CBCT) measurements with clinical presurgical and intrasurgical measurements in the lower molars with furcation involvements (FIs). The sample consisted of 22 lower molars diagnosed with FI. The presurgical clinical examination included assessments of the probing depth, clinical attachment level, and horizontal bone loss (H-BL). Tomographic and intrasurgical measurements were taken to evaluate the vertical bone loss (V-BL), the distance of the cementoenamel junction to the base of the bone defect (CEJ-B), the horizontal bone loss (H-BL), root trunk length (RT), and furcation entrance width (FEW). Statistical analysis was performed, and values with p < 0.05 were considered statistically significant. The study of horizontal bone involvement showed a high level of agreement between presurgical, intrasurgical, and tomographic assessments. Strong correlations were found between intrasurgical and CBCT measurements for H-BL and furcation entrance width. Regarding the intrasurgical evaluation, class I FI was more prevalent, while class II FI was more frequently identified in CBCT evaluations. H-BL was significantly greater in class II FI compared to class I lesions. Moreover, the V-BL was greater in subclass B FI than in subclass A lesions. We found a strong correlation between horizontal furcation involvement measurements from CBCT and intrasurgical exams. CBCT was more accurate in assessing furcation morphology and vertical bone defects, making it a valuable complementary tool for decision-making in the surgical management of furcation involvements.