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Perio > Management Of Furcation Involved Teeth > Flashcards

Management Of Furcation Involved Teeth Flashcards

1
Q

Furcation are a significant predictor for

A

Tooth loss helal et al 2019

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2
Q

Where is the furcation for upper first premolar

A

7-9mm subgingival Booker and Laughlin 1985

Furcation involvement means ≥50% clinical attachment loss

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3
Q

Anatomical feature of maxillary first premolar that makes it easy for plaque to accumulate

A

Mesial root groove/concavity present in 100% of first premolars

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4
Q

What is a fornix

A

A concavity in the molars that lead to the furcation (from the tooth trunk)

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5
Q

Where is the furcation for max first molar

A

Mesial 3.6mm
Distal 4.8mm
Buccal 4.2mm

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6
Q

Where is the furcation for mand first molar

A

Buccal 3mm

Lingual 4mm

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7
Q

Root concavities mandibular molar

A

Distal (0.5mm) 99%

Mesial (0.7mm) 100%

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8
Q

Root concavities maxillary molar

A

Mesial (0.3mm) 94%
Buccal (0.1mm) 17%
Distal (0.1mm) 31%

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9
Q

What is a bifurcation ridge

A

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

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10
Q

Grade a cervical enamel projection that extends 2/3 into the root trunk

A

Grade II

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11
Q

How often do we see furcation involvement

A

In population of periodontitis patients, furcation involvement found in 33% of all molars

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12
Q

How much bone min to place implant

A

6mm

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13
Q

Survival rate of resected molars

A

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)

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14
Q

Survival rate of molars treated with regeneration

A

83-100% survival at 5-12 years Huang-ba et al 2009

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15
Q

Risk of losing furcation involved teeth during periodontal maintenance phase

A

2.54 times higher Wang et al 1994

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16
Q

What is furcation tunneling

A

Resect bone to widen furcation to make it accessible for oral hygiene procedure

17
Q

Furcation tunneling can only be done for

A

Lower molars. First lower molars better because second molar roots are more convergent

18
Q

Tooth loss % for tunneled molars

A

29.4%, significantly associated with irregular periodontal maintenance and age

19
Q

What is the benefit of open debridement

A

Surgical procedure, move gums away from bone and teeth. Open debridement higher chance of cleaning root swell and rendering roots calculus free

20
Q

Why should endo treatment be done before regenerative surgery

A

Remove a source of infection

21
Q

Root resection preferred if root involved is

Max molar

A

DB root

22
Q

Mean survival time for molars with grade iiI furcation

A

11.8 years

23
Q

Mean survival time for molars with >60% bone loss

A

14.4 years

24
Q

What is the objective of conservative treatment of furcation involved teeth

A

LA Scrp, access flap surgeries, tunnel preparation

Objective is to remove residual bacteria, improve self performed plaque control

25
Q

Objective of regenerative treatment to treat furcation involved teeth

A

Eliminate furcation defect

26
Q

Objective of resective surgery

A

Eliminate inter radicular lesion. Open up furcation easily, create area for easier plaque removal

27
Q

Why are ultrasonics preferred to clean furcation

A

Narrower tip with different angulation, better for debriding hard to reach areas

Faster, able to significantly reduce bacteria count

28
Q

Waterpik vs sonic air floss

A

Waterpik better clinical and histologically reduction in gingival inflammation

29
Q

Furcation tunneling is only done for

A

Lower molars

First lower molars better because second molars roots more convergent

Stable (mob 1,2) with deep II or III furcation involvement

30
Q

Tooth loss for tunneled molars

A

29.4%, significantly associated with irregular periodontal maintenance and age

31
Q

Horizontal probing attachment level gains and bone level gains for guided tissue regeneration

A

Attachment level gains: 0.75 to 4.1mm

Bone level gains: 0.2 to 4.5mm

32
Q

Guided issue regeneration good for which class of defects

A

Class II

33
Q

Success of gtr dependent on

A

Defect size (vertical defect≤4mm more favourable for closure)
Proximal bone to level of furcation
Thickness of gingiva (>1mm more favourable)
Ability to clean properly
Smoking, diabetes
Root convergence

34
Q

Treatment choice for furcation I, II, III

A

I: closed debridement, furcation plasty, odontoplasty

II: furcation plasty, tunnel prep, root resection, GTR

III: tunnel prep, root resection, tooth extraction

35
Q

Which root in max molar has greatest surface area

A

Palatal root

Perio (18 decks)

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