Treatment of maxillary molar with furcation involvement - Case report

Abstract

Purposes: The aim of this clinical report is to discuss the advantages and the steps of the root separation and resection approach in a maxillary molar with a class III furcation of the palatine root with a follow-up of 24 months. Case report: A patient with tooth mobility and bleeding after probing, was diagnosed with a Chronic Periodontitis Generalized Moderate and Localized Severe. Hygienic phase with oral hygiene instructions, scaling and root planning was performed. Due to class III furcation of the palatine root of the teeth 16 and some remaining pockets deepths, was decided to execute an apical repositioning flap on the 1st sextant among with the palatine root amputation combined with the endodontic treatment. During the surgical procedure, it was also performed a reduction of the palate thickness from teeth 15 to 17; in distal area of the 17 a distal wedged was performed in order to remove all the pockets. After the surgery, the patient was inserted in a long-lasting individualized supportive periodontal treatment.This case has a follow up of 24 months. Conclusions: Similar survival rates are described in the literature when we compared the root amputation with the dental implants survival rate, but the first one is cheaper and allows to keep the natural tooth. We can’t forget that the periodontitis is a risk factor of peri-implantitis. This clinical case shows that, with a high motivated patient and with the complete periodontal treatment, is possible to obtain excellent results with root separation and resection in maxillary molars class III.