Periodontal Furcation Diagnosis

Question 1

What is a periodontal furcation?

Answer 1

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

Question 2

Is it more common for maxillary or mandibular teeth to have furcations?

Answer 2

Maxillary

Question 3

What is the anatomy of maxillary molar roots?

Answer 3

Palatal
Disto-buccal
Mesio-buccal

Mesio-buccal and palatal roots are larger than disto-buccal roots.

Question 4

Why is it important to make an endodontic diagnosis for furcations?

Answer 4

• Accessory canals in the furcation areas that may have a communication between endodontic and periodontal pathologies
• Primary endodontic lesions may resemble furcation involvement
• Vitality and periodontal probing is essential for differential diagnosis
• Some periodontal therapies for furcation lesions do not benefit from any preventative root canal treatment

Question 5

What is the technique to probing a maxillary furcation?

Answer 5

Find the buccal entrance which is 3.5mm from the cej apically.
On the mesial side, tend to probe from the palatal side - 3mm from CEJ
The distal entrance is usually 5mm apical to the CEJ.

Question 6

What is the technique to probing a mandibular furcation?

Answer 6

Mandibular furcations are more accessible as there is only 2 roots so need to probe mid buccal and mid lingual.
Buccal entrance = 3mm from CEJ
Lingual entrance = 4mm from CEJ

Question 7

What defines the degree of the furcation?

Answer 7

Degree 1 = horizontal loss of periodontal support up to 3mm

Degree 2 = horizontal loss of periodontal support >3mm but not through

Degree 3 = through and through loss of periodontal support

Question 8

Is a vertical or horizontal furcation more likely to cause tooth loss?

Answer 8

Vertical