Furcation Involvement & Its Treatment: A Review. Article (PDF Available) in Journal of Advanced Medical and Dental Sciences Research. Shikai Tenbo. ;51(3) [Furcation involvement and its management]. [ Article in Japanese]. Hasegawa K, Miyashita H, Kinoshita S. PMID: The management of furcation involvement presents one of the greatest . The membrane was soaked in normal saline solution to improve its adhesion.
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These include 21The root trunk imvolvement Size of the furcation Root separation and divergence Root fusion Root concavity Crown root ratio of the tooth Occlusal interferences and trauma from occlusion Tooth mobility Adherence of the gum The ease with which hygiene of the affected furcation can be maintained The capacity of the patient to maintain optimum hygiene The extent of furcation disease can be determined by evaluating Vertical bone loss Horizontal bone loss Both vertical and horizontal bone loss Out of horizontal and vertical bone loss parameters, the horizontal bone loss is more commonly used parameter.
The furcation fornix is referred to as the roof of furcation area and furcation entrance is the transitional area between the divided and undivided roots. Other predisposing and contributing factors which facilitate furcation involvement furcarion tooth brush trauma causing recession and loss of attachment, trauma from occlusion, endodontic lesions that get an access to furcation area, the thickness of investing alveolar process, root fracture and iatrogenic knvolvement.
Root separation is indicated as the sectioning of the root complex and the maintenance of all roots Bicuspidization is one of the procedures for management of furcation involvement in mandibular molars. involvemwnt
Furcation involvement and its treatment –
Open or closed flap debridement without modification of the furcation has been shown to be not very effective in the management of Grade II furcation defects. Efficiency of scaling the molar furcation area with and without surgical access.
Furcationplasty can be applied to the buccal and lingual furcation areas. Out of horizontal and vertical bone loss parameters, the horizontal bone loss is more commonly used parameter. The studies included in this systematic review were analyzed for furcation closure rate, horizontal attachment level gain HALvertical attachment level gain VALhorizontal bone fill HBFand vertical bone fill VBF.
Regeneration of new intrafurcal bone and attachment can be expected in such cases. Biological aspect Dental implants: On the other hand, Kalkwarf et al. The pocket is suprabony, involving the soft tissue and there is a slight bone loss in the furcation area. Contraindications for the procedure involve poor oral hygiene, fused roots, unfavorable tissue architecture and roots which are endodontically untreatable.
However, complete hard and soft tissue formation may take as long as 6 months or manageement. Interradicular bone is completely absent. Presurgical vertical measurement at the control site with the stent.
Classification by Tarnow and Fletcher: This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3. When seen from the mesial surface, the mesiobuccal root occupies two-thirds of the buccolingual measurement of the tooth and it hides the distobuccal root. Grade II or Cul-de-sac like fucation defect can be treated by both regenerative and resective procedures.
[Furcation involvement and its management].
These changes reflect reduction of the horizontal inter-radicular probe penetration. Maintenance of adequate oral hygiene is required for preventing furcation lesion from progression. Regeneration by grafting may be further enhanced by the use of barrier membranes that exclude gingival fibroblasts and epithelium from the healing site. The development of furcation lesions has also been demonstrated due to inappropriate treatments.
[Furcation involvement and its management].
The review included articles, of which six were systematic reviews, were clinical trials, 27 were case series, and eight were case reports. The treatment performed included coronal scaling only, scaling and root planing, scaling and root planing plus modified Widman flap, and open flap scaling and root planing with osseous resection.
Presently, there is no uniformity in the terms used to describe various treatments for teeth with furcation involvement. Tooth anatomy Tooth mobility Crown-root ratio Severity of attachment loss Inter-arch and intra-arch occlusal relationship Cost-benefit ratio for retaining a portion of the root Patient-related factors: As already stated, hemisection involves removing significantly compromised root structure and the associated coronal structure through deliberate excision The appropriate amount of the bone graft was taken in a container and transferred to a sterilized dappendish, to which a few drops of saline were added.
The authors stated that various treatment modalities for molars with furcation involvement are selected based on the depth of furcation involvement. Glickman 22 proposed classification for furcation involvement were four grades of furcation involvement were described. Root resection generally indicates the removal of a root without any information on the crown of the tooth It is important to determine the extent of furcation involvement to a make an appropriate diagnosis and developing a treatment plan.
The root cones start at the furcation point from where they may take various shapes diverging from the root trunk. Six months postsurgical horizontal measurements at the control site with the stent.
Furcation involvement is primarily due to the rootward extension of the periodontal pocket in the region of furcation. The incompletely fused roots may be fused in the area of CEJ but are separated in the apical region. Received Oct 14; Accepted Apr Maxillary second and third molars: The coronal portion of the membrane was tightly secured to the cementoenamel junction CEJ of the tooth, with chromic catgut sutures [ Figure 10 ].
The maxillary first molar is the largest tooth in the maxillary dental arch. Let us now discuss the anatomy of various bifurcated and trifurcated teeth in detail.
Extent of attachment loss on furcation involvemment on presence of these factors: All the depressions found on the root surface of the second molar are usually shallower than the first molar. Surgical management Four to six weeks after scaling and root planing and just prior to the surgical procedure, each subject was re-examined and baseline data were recorded. This is named as a Cul-de-sac which means a dead end street.
Health of a patient Importance of the tooth to the patient Costs and time factor Clinician-related factors: The recall interval andd patients with furcation involvement is comparatively shorter than the patients with no furcation involvement. Another treatment is covering the furcation with periodontal plastic surgery.
Houser et al [ 15 ] showed a mean difference of 2. In mandibular molars, the procedure involves removal of one root with retaining the complete crown of the tooth.