Furcation Involvement Flashcards
What is furcation involvement
Pathologic bone loss in anatomic area of multi rooted teeth
What is the aetiology of furcation
Plaque
Anatomy
Pulpal Issues
Iatrogenic
What is the size of furcation entrance
81% below 1 mm
58% below 0.75 mm
What % of patients have furcation below 0.75
58%
What is Glickmans furcation classification
1: Into fluting
2: Cul de sac
3: Through and through
4: Through and through and see through
What is Hamps classification of furcations
1: below 3 mm
2: above 3mm
3: through and through
What is Tarnow classification of furcations
- from dome to base of probing
A: 0 - 3 mm
B: 3 - 6 mm
C: above 6 mm
What is the relevance of Tarnow’s classification
Ameniability to grafting
What is the goal of furcation treatment
Stop further attachment loss
Retain tooth
Regeneration
How do you manage a moderate furcation defect
Treatment varies with height and volume of attachment loss
Configuration of defect
Tooth anatomy
must obliterate furcation
What is ostetoplasty
reduce bone deformity
What is odontoplasty
Reduce tooth deformity
Decrease volume
reduce intermed bifurcation ridge
Why resect root
Obliterate furcation while leaving the crown in function
Indication of root resection
Severe vertical BL Furcation Invasion NOT correctable with odontoplasty Not maintainable Hopeless root Fractured tooth Root dehisence Cannot do endo on one root Root resorption on root
Contra indication of root resection
Advanced bone loss Fused roots Canals not endo-able Not good abutment Poor perio support Poor OH $
Which root to remove
One with the least amount of support
Obliterate furcation
Eliminate associated defect
Plaque removal possible
what is the number 1 cause of failure
Leave lip of bone behind
Restorative consideration for root resection / hemi section
Remaining root length
Internal anatomy
What is the prognosis of root resection / hemi section
3.4 % failure
90% at 5 years
Discuss tunnelling
Remove bone to make open tunnel
Not many molars wide enough roots
Most common issue with tunneling
Caries
What furcation responds best to treatment
Grade II
