Management Of Furcation Involved Teeth Flashcards
Furcation are a significant predictor for
Tooth loss helal et al 2019
Where is the furcation for upper first premolar
7-9mm subgingival Booker and Laughlin 1985
Furcation involvement means ≥50% clinical attachment loss
Anatomical feature of maxillary first premolar that makes it easy for plaque to accumulate
Mesial root groove/concavity present in 100% of first premolars
What is a fornix
A concavity in the molars that lead to the furcation (from the tooth trunk)
Where is the furcation for max first molar
Mesial 3.6mm
Distal 4.8mm
Buccal 4.2mm
Where is the furcation for mand first molar
Buccal 3mm
Lingual 4mm
Root concavities mandibular molar
Distal (0.5mm) 99%
Mesial (0.7mm) 100%
Root concavities maxillary molar
Mesial (0.3mm) 94%
Buccal (0.1mm) 17%
Distal (0.1mm) 31%
What is a bifurcation ridge
Developmental ridge that runs in buccolingual direction
Intermediate bifurcation ridge in mesiodistal direction made up of primarily cementum. Extra ridge in roof of furcation makes it harder to clean, increased risk of breakdown
Grade a cervical enamel projection that extends 2/3 into the root trunk
Grade II
How often do we see furcation involvement
In population of periodontitis patients, furcation involvement found in 33% of all molars
How much bone min to place implant
6mm
Survival rate of resected molars
93% after 10 year observation with good OH carnevale et al 1998
96.8% cumulatively fugazzatto 2001, comparable with 97% for implants in molar position (inclusive of non perio related implants; 92% in perio patients)
Survival rate of molars treated with regeneration
83-100% survival at 5-12 years Huang-ba et al 2009
Risk of losing furcation involved teeth during periodontal maintenance phase
2.54 times higher Wang et al 1994
What is furcation tunneling
Resect bone to widen furcation to make it accessible for oral hygiene procedure
Furcation tunneling can only be done for
Lower molars. First lower molars better because second molar roots are more convergent
Tooth loss % for tunneled molars
29.4%, significantly associated with irregular periodontal maintenance and age
What is the benefit of open debridement
Surgical procedure, move gums away from bone and teeth. Open debridement higher chance of cleaning root swell and rendering roots calculus free
Why should endo treatment be done before regenerative surgery
Remove a source of infection
Root resection preferred if root involved is
Max molar
DB root
Mean survival time for molars with grade iiI furcation
11.8 years
Mean survival time for molars with >60% bone loss
14.4 years
What is the objective of conservative treatment of furcation involved teeth
LA Scrp, access flap surgeries, tunnel preparation
Objective is to remove residual bacteria, improve self performed plaque control
