Periodontitis - furcation-involved Flashcards

1
Q

Which tooth is most affected for furcation involvement?

A

Distal of upper molars
Cervical enamel projections and pearls have been
associated with up to 76% of furcation involved molars

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2
Q

Classification of furcation?

A
  • I - < 1/3 tooth width
  • II - >1/3 tooth width
  • III - through & through
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3
Q

What instrument to measure a furcation?

A

Nabers

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4
Q

Classificaiton of vertical invasion of furcation?

A
  • Subclass A: 0–3 mm.
  • Subclass B: 4–6 mm.
  • Subclass C: >7 mm.
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5
Q

Prognosis of furcation involved teeth?

A
  • Teeth with grade III FI were 7 times
  • Teeth with grade II FI were 3 times
  • Teeth with grade I FI were no more
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6
Q

Retain or replace furcation involed molars?

A

Retaining FI molars with periodontal treatment was
found to be more cost effective than replacing them
with implant supported crowns.

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7
Q

Name the 4 factors with increased likelihood of XLA of furcation involved teeth?

A
  • Tobacco smoking
  • Maxillary molars
  • PPD>/= 4mm
  • No SPT
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8
Q

Name the tx options for furcation involved teeth?

A
  • Non-surgical periodontal treatment
  • Surgical periodontal treatment
    - Access +/- apical repositioning
    - Resective
    - Furcal tunnelling
    - Root resection
    * Regenerative
    - Guided bone regeneration
    - Enamel matrix derivative
  • Endo-perio lesions require root canal treatment
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9
Q

What can influence descision making for tx options for furcation involved molars?

A

Patient compliance (plaque,
tobacco, HbA1c).
* Patient attitude
* Patients general health
* Furcal anatomy
* Ability to access
* Clinical skills & access to
specialist services

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10
Q

PMPR?

A

crosshatching is best technique

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11
Q

What is the definition and pre-requisites for furcal tunnelling?

A

Inter-radicular space is created in order to provide better access for the patient when brushing between the roots
Pre-requisites
* Compliance
* No detectable mobility
* Grade II or II FI
* Sufficient root divergence
* Sufficient bone support
(minimum 1/3 of teach root cone)

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12
Q

What is the definition and indication for root resection?

A

Root resection involves the sectioning of multirooted teeth and
removal of one or two of the roots.
Indications:
* Deep Class II and Class III furcated molars with severe root
proximity or a long root trunk
* Severe bone loss affecting one or more molars with or without
furcation involvement
* Untreatable apical endodontic lesion affecting one root
* Severe root decay or resorption
* Severe recession or dehiscence affecting one root

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13
Q

Name 2 bioactive regenrative materials for furcation-inviolved molars?

A

Enamel matrix derivative
(EMD)
* Plasma rich growth factor
(PRGF)

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