Management of periodontal furcation defects employing molar bisection; a case report with review of the literature

Abstract

Introduction: The management and long-term retention of molars exhibiting furcation invasion have always been a challenge in dentistry. Latest innovations in dental sciences and higher patient's expectations have led to more conservative treatment approaches in saving the teeth with hopeless periodontal prognosis. When periodontal disease affects the furcation area of tooth, the chance of its exfoliation increase considerably. Here, authors have sought to discuss a comprehensive review of literature with case report for the management of decayed mandibular first molars (with furcation invasion) using bicuspidization procedure. Case Report: The furcation defect (in mandibular first molars) was clinically detected in a middle aged male, which was converted into two bicuspids by intentional bisection procedures. The definitive treatment included restoration with double crowns. Bicuspidization procedure with double metal crowns truly yielded a satisfactory result. Discussion: The treatment of furcations affected by periodontal disease is one of the most difficult problems for the general dentist and periodontist. An increase in the exposed root surface, anatomical peculiarities and irregularities of the furcation surface all favor the growth of bacteria. These problems make it harder for the patient to maintain hygiene, and impede adequate treatment. Bisection/bicuspidization of the decayed molars can be a practicable treatment option when there is vertical bone loss involving root/roots with furcation defect. In real terms, it is the separation of mesial and distal roots of mandibular molars along with its crown portion, where both segments are then retained individually.