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Variables with documented influence on regenerative outcomes or long-term tooth survival were extracted and grouped into two conceptual axes: a Morphological Regenerability Score, capturing defect anatomy, and a Maintenance Accessibility Score, capturing site-related and patient-related factors. Scoring ranges and thresholds were derived from the magnitude and consistency of reported effect sizes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The Morphological Regenerability Score integrates five defect-related variables (vertical furcation involvement component, root divergence at crestal bone, furcation entrance width, defect location and root trunk length) with modifiers for mobility, cervical enamel projections, exposed furcation entrance, and enamel pearls, spanning\u2009\u2212\u20095 to 9 points. The Maintenance Accessibility Score integrates seven maintenance-related variables (plaque control, supportive periodontal treatment compliance, smoking, diabetes control, site\/operator accessibility, endodontic status and tissue phenotype), spanning 0 to 13 points. Midpoint thresholds (MRS\u2009\u2265\u20095; MAS\u2009\u2265\u20097) define four clinical quadrants guiding case selection between regeneration, staged treatment strategy, non-surgical or resective approaches, and extraction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The proposed framework consolidates heterogeneous evidence on Class II furcation involvement prognosis and proposed treatment strategies into a single transparent decision aid. Prospective validation is required before routine clinical adoption.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical relevance<\/jats:title>\n                    <jats:p>This framework supports evidence-based, individualised decision-making for Class II furcation involvement based on defect regenerability and long-term maintenance, and highlights modifiable risk factors that should be addressed before attempting regenerative surgery.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00784-026-07039-8","type":"journal-article","created":{"date-parts":[[2026,7,18]],"date-time":"2026-07-18T08:07:02Z","timestamp":1784362022000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A conceptual regeneration\u2013maintenance decision aid for class II furcation involvement"],"prefix":"10.1007","volume":"30","author":[{"given":"Anete","family":"Va\u0161kevica","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meltem","family":"\u00d6zdemir Kabalak","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jenna","family":"Kompuinen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilze","family":"Akota","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulvi Kahraman","family":"G\u00fcrsoy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johan Caspar","family":"Wohlfahrt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,18]]},"reference":[{"key":"7039_CR1","doi-asserted-by":"publisher","first-page":"730","DOI":"10.1034\/j.1600-051x.2001.280803.x","volume":"28","author":"KF Al-Shammari","year":"2001","unstructured":"Al-Shammari KF, Kazor CE, Wang HL (2001) Molar root anatomy and management of furcation defects. 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