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Bds3 - RMAOH PERIODONTOLOGY > Furcation Management > Flashcards

Furcation Management Flashcards

1
Q

PERIODONTAL FURCATION INVOLVEMENT is:

A

Loss of periodontal attachment and bone in the root separation area of multirooted teeth, due to progression of periodontitis

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2
Q

Label

A
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3
Q

Maxillary molars
Usually have how many roots?

A

3 = MB, DB + P, db is smaller

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4
Q

Mandibular molars
How many roots

A

2 - Mesial + Distal

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5
Q

Furcation - special anatomy

What is a furcation ridge ?

A

Furcation ridges = ridges of cementum in the furcation area

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6
Q

What problem do both Cervical enamel projections and Enamel pearls cause?

A

Plaque retentive

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7
Q

When you have furcations why is endodontic diagnosis so important ?

A
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8
Q

What might accessory canals in furcation region cause

A

Accessory canals in the furcation region are frequent and might represent a communication pathway between endodontic and periodontal pathologies

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9
Q

What might Primary endodontic lesions resemble ?

A

Primary endodontic lesions might resemble a furcation class III periodontal defect, when the fistulous sinus tract drains through the inter‐radicular space

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10
Q

Maxillary first molar
How do we enter furcation:
Buccally?
Mesially?
Distally?

A
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11
Q

Premolars
How Do we enter furcation space?

A
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12
Q

Mandibular molar
How do we enter furcation

A
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13
Q

What probe should you use to locate furcations and how do you use to measure the horizontal component of the furcation?
What is there a risk of?

A
  1. Nabers probe as it is curved.
  2. Rotate the probe to measure the horizontal component of the furcation.
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14
Q

In addition to Nabers probe what can we use for furcation diagnosis

A

Radiograph

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15
Q

Radiographic diagnosis of furcation
1 - How is it diagnosed?
2 - Are furcations often missed clinically? What can we do for this

A

1-
• Image of radiolucency in proximity of root separation area
• Triangular shadow in the proximal furcation area

2 - Yes esp grade 3 in maxillary molars so we can sometimes use CBCT

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16
Q

Furcation
How do we measure the horizontal involvement of furcation?

A

Degree I = horizontal loss of periodontal support up to 3mm

Degree II = horizontal loss of periodontal support > 3mm but not through

Degree III = through and through loss of periodontal support

Also referred to as class 1-3

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17
Q

Furcation
Although the main measurement is horizontal for furcation - degrees - what can we use to measure VERTICAL involvement

Need to know??

A

Class A, B ,C
(Tarnow and fletcher)

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18
Q
A
19
Q

How is furcation linked with tooth loss?

A

Tooth with no furcation highest change of survival

As you go from furcation degree 1 to 3 (through and through ), have increased risk of tooth loss

However even if we have a furcation tooth we can still retain it for long time with correct treatment

20
Q

what is done if:
- no furcation on probing
- probing degree I
- probing degree II or III

A
21
Q

SECTION 2 - FURCATION MANAGEMENT STRATEGIES

A
22
Q

Furcations
What are aims of therapy

A
23
Q

Furcation management
What are the 5 different options ?

A

Root resection = removing one root and leaving remaining
Tunnelling = allowing access for furcation so patient can clean in between furcation

24
Q
  1. Non surgical therapy

Does it work as well as on non furcated tooth

A

Less predictable response with teeth with furcations

Hard to clean / remove calculus in furcation areas for both dentist and patient

25
Q
  1. Non surgical therapy
    What is the width of furcation entrance

What instruments can we use?

A
26
Q

1 non surgical debridement tools and their width

A
27
Q

What curette tips are advised for manual furcation debridement and why?

A

Micro mini-five curette

As its 0.6mm and furcation entrances are normally between 0.75 to 0.1 in first molars.
28
Q

What is more useful in furcation debridement of degree 2 and 3 furcations than curettes

A

Ultrasonic furcation tips

29
Q

Manual furcation debridement

A

Curettes

30
Q

What ultrasonic tips are advised for ultrasonic furcation debridement and why?

A

They are curved and are at 0.5-0.6mm which is perfect for the 0.7-1.1mm entrance for furcations.

31
Q
A
32
Q

REGENERATIVE THERAPY

What are the 3 aims with regenerative therapy for furcations?

A
33
Q

REGENERATIVE THERAPY

What are 4 options of regenerative therapy for furcations?

A
34
Q

RESECTIVE THERAPY

What are the 2 aims with resective therapy for furcations?

A
35
Q

RESECTIVE THERAPY

What are 3 options of resective therapy for furcations?

A
36
Q

Resective therapy

A
37
Q

TUNNELLING
What are the 2 aims

A
38
Q

For degree I furcation what are the treatment options ?

A

Supportive periodontal therapy

39
Q

For degree II furcations, what are the treatment options?

A
  1. Regeneration - mainly mandibular with good interdental bone peaks
  2. Supportive periodontal therapy
  3. Access flap
  4. Resection / Tunnelling

(Regen techniques more successful than open flap debridement )

40
Q

For degree III furcations, what are the treatment options

A
  1. Resection/ Tunnelling
  2. Supportive periodontal therapy
  3. Access flap
  4. Extraction
41
Q

Implant vs keeping molars with FI

A

Implant also lead to reduced bone quantity and quality , risk of peri implantitis

42
Q

When can tunnelling be successful

A

If root divergence exceeds 30 degrees

43
Q

what are the patient AND tooth factors to consider in furcation decisions making

A
44
Q

If a restoration is used to block a furcation what can occur as a downside?

A

Caries

Bds3 - RMAOH PERIODONTOLOGY (21 decks)

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