Treatment Of Furcation Involvement Research Articles

Clinical diagnosis and treatment of furcation involvement

Furcation involvement (FI) is the lesion and destruction of periodontium that spread to the root furcation of multi-root teeth, where periodontal pockets, loss of periodontal attachment and resorption of alveolar bone are formed. Furcation involvement is a common concomitant lesion of periodontitis. The severity of furcation involvement can directly affect the prognosis of periodontitis. However, the specificity of the anatomical structure of the root furcation greatly increases the difficulty of treatment. Therefore, early detection and treatment of furcation involvement is crucial for the prevention and control of periodontitis. This paper briefly describes the pathogenesis of furcation involvement and discusses the diagnosis, classification and treatment of this disease, which is helpful to improve the clinical diagnosis and treatment of furcation involvement.

Calcium sulfate: An unconventional bone graft in the management of furcation involvement – A case series

This case series is an attempt to evaluate the potentials of calcium sulfate as a regenerative modality in the treatment of furcation involvement. Conventionally, different types of alloplastic bone grafts such as demineralized freeze-dried bone allograft, freeze-dried bone allograft, beta-tricalcium phosphate (β-TCP), hydroxyapatite, bioactive glass, or a combination of these with barrier membrane have been employed. Very few studies have been carried out on human furcation involvement using calcium sulfate bone graft. The results obtained were encouraging in terms of regeneration. This case series sheds light on calcium sulfate in the management of furcal involvement.

Incidence and treatment of furcation involvements in a Brazilian dental school. Epidemiologic data.

The aim of the present study was to determinate the incidence of these defects and the therapeutic approaches employed in 105 patients attended in a Brazilian dental school. One-hundred five periodontal charts of patients attended at the Dental Clinic of the Unicamp Dental School were examined, in order to find furcation lesions in molar and premolar teeth (upper and/or lower). The results showed that these 105 subjects exhibited 216 teeth with furcation involvements (131 at the upper jaw and 85 at the lower jaw). It represented a percentual score of furcation defects by jaw: 60.6% at the upper jaw and 39.4% at the lower jaw. The incidence of furcation lesions was higher at the first molar in all of the quadrants and the higher incidence of these defects was on the tooth #16 (34%) and the upper buccal furcation defect was the more incident in this sample (28.2%). The predominant type of furcation lesion at the upper jaw was the class I defect (61.5%) and the more prevalent defect in the lower jaw was class I (65.8%). Considering both the archs, the class I defect appeared in 60.2% of the cases, class II´s, 30.1%, and class III´s, 9.7%. The more used therapeutic approach for furcation involvements was scaling and root planing (69.9%). These data suggest that the upper teeth are more affected by furcation lesions than the lower teeth; the furcation lesions are more frequent on the first molar in all of the quadrants; the class I is the more frequent type of furcation lesion; and the more frequently used approach to treat furcation involvement was scaling and root planing.

Types and dimensions of root trunk correlating with diagnosis of molar furcation involvements.

The objective of the present study was to investigate the possible correlation of dimension, location, prevalence, and types of root trunk with molar furcation involvement (FI). The samples used in the study include 166 maxillary molars (70 1st and 96 2nd molars) and 200 mandibular molars (103 1st and 97 2nd molars). The dimensions of the root trunks and root lengths were measured with an electric caliper and their means and standard deviations calculated. The types of root trunks were identified by the ratio of root trunk dimension to root length and classified as types A, B, and C. The results may be summarized as follows. (1) Short-root trunks were more commonly found buccally, whereas long-root trunks were more commonly found mesially, in both maxillary molars. (2) Short-root trunks were most commonly found buccally, whereas long-root trunks were more commonly found lingually in both mandibular molars. (3) Long-root trunks were more commonly found on the 2nd molars than on the 1st molars. (4) Long-root trunks were associated with short root length. (5) There is a strong correlation between vertical length and type of root trunk and FI. The findings of the study indicated that an awareness of root trunk type together with horizontal and vertical attachment levels in molar FI may be helpful in the prognosis, diagnosis, and treatment of molar FI.

Current Status of Periodontal Therapy for Furcation Involvements

The treatment of furcation involvements is difficult because of the anatomic problems that interfere with the clinician's accessibility in treating the area and the patient's ability in maintaining adequate plaque control afterwards. The goal of traditional methods of treatment is to arrest the progression of bone loss; the rate of success with these methods has been poor, except for Grade I involvements. Advances in the last decade have resulted in the development of treatment techniques that attempt to reconstruct the lost periodontal structures. These techniques have greatly improved the prognosis of Grade II furcation involvement. The recommended technique combines the principles of guided tissue regeneration using polytetrafluoroethylene membranes with grafting with porous hydroxyapatite. The use of decalcified freeze-dried bone instead of hydroxyapatite also may be a successful method. Grade III and IV furcation involvements still have a poor long-term prognosis because predictable reconstructive techniques for their treatment have not been demonstrated. When possible, a root resection approach may be advisable.

Therapeutic effects of combined treatment using tetracycline‐immobilized collagen film and root planing in periodontal furcation pockets

46 upper and lower molars with furcation grade II involvement were selected from 16 patients with periodontal disease. The teeth were randomly allocated to the following groups according to treatment; (1) 4 consecutive administrations of tetracycline-immobilized cross-linked collagen film (TC film) at intervals of 1 week (TC group); (2) 1 root planing treatment (RP group); (3) combination treatment (TC + RP group); (4) no treatment (control group). The therapeutic effects of each treatment were compared both clinically and microbiologically. Records of plaque index, gingival index, bleeding on probing, probing depth, probing attachment level and microscopic counts were obtained at 0, 4, 6 and 8 weeks. The results showed marked decreases in probing depth and density of micro-organisms in both the RP and TC + RP groups. In particular, the TC + RP group was characterized by a decreased rate of bleeding on pocket probing and an increased probing attachment gain. The above findings demonstrated that root planning is effective in the treatment of furcation involvement and that the effects are enhanced by the local administration of TC films.

Periodontal treatment of multirooted teeth. Results after 5 years.

This paper describes: (1) a system for classification and treatment of furcation involvements, and (2) a 5-year post-operative evaluation of 100 patients treated for periodontal breakdown in the bi/tri-function areas. The results of this study demonstrate that it is possible to arrest further destruction within the root furcation area. The successful treatment of the multirooted teeth was probably the consequence of: (1) the quasi total elimination of plaque retention areas from the bi/tri-furcation area, and (2) meticulous oral hygiene by the patients.