Periodontitis - furcation-involved

Question 1

Which tooth is most affected for furcation involvement?

Answer 1

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

Question 2

Classification of furcation?

Answer 2

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

Question 3

What instrument to measure a furcation?

Answer 3

Nabers

Question 4

Classificaiton of vertical invasion of furcation?

Answer 4

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

Question 5

Prognosis of furcation involved teeth?

Answer 5

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

Question 6

Retain or replace furcation involed molars?

Answer 6

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

Question 7

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

Answer 7

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

Question 8

Name the tx options for furcation involved teeth?

Answer 8

• 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

Question 9

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

Answer 9

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

Question 10

PMPR?

Answer 10

crosshatching is best technique

Question 11

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

Answer 11

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)

Question 12

What is the definition and indication for root resection?

Answer 12

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

Question 13

Name 2 bioactive regenrative materials for furcation-inviolved molars?

Answer 13

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