Furcation Involvement Definition
Furcation involvement
- Furcation involvement refers to the invasion of the bifurcation and trifurcation of multirooted teeth by periodontal disease.
Root resection
- It is the surgical removal of all or a portion of the root before or after endodontic treatment.
Hemisection
- One root with its corresponding crown portion is cut and removed
Bicuspidisation
- The molar is cut without the removal of any part of the crown or root
Furcation Involvement Important Notes
1. Types of furcation
Read And Learn More: Periodontics Question and Answers
Furcation Involvement Long Essays
Question 1. Define and classify furcation. Enumerate treatment of grade III furcation areas.
Answer:
Furcation Definition:
- Furcation involvement refers to the invasion of the bifurcation and trifurcation of multirooted teeth by periodontal disease.
Classification of furcation:
1. According to Glickman:
- Grade 1
- Early/Incipient lesion
- Suprabony pocket
- Slight bone loss
- No radiographic changes
- Grade 2
- Bone destruction on one/more aspects
- But the portion of the bone is intact
- Cul-de-sac lesion
- A radiograph may or may not reveal the involvement
- Grade 3
- Complete inter-radicular bone loss
- No soft tissue loss
- Radiograph shows the radiolucent area between roots
- Grade 4
- Inter-radicular bone loss
- Gingival recession
- Radiolucent area radiographically
2. According to Tarnow & Fletcher:
- Subgroup A: Vertical bone loss upto 1/3rd of inter-radicular height (0-3 mm)
- Subgroup B: Vertical bone loss upto 2/3rd of inter-radicular height (4-7 mm)
- Subgroup C: Vertical bone loss beyond apical third (>7 mm)
Treatment:
Objectives:
- Facilitate maintenance
- Prevent further attachment loss
- Obliterate furcation defects
Treatment Options:
1. For grade 1
- Scaling and root planning
- Grade I can be accessible by scaling and root planning
- Curettage
- Done by Gracey curettes, Quetin furcation cu- rettes
- Gingivectomy
- It is the excision of the soft tissue wall
2. For grade 2
- Traditional methods
- Scaling and root planning- inaccessible areas
- Curettage
- Osteoplasty
- It involves shaping of bone to prevent plaque accumulation
- Hemisection
- It is the surgical removal of the root with the associated part of the crown
- Regenerative procedures
- GTR (Guided Tissue Regeneration)
- It involves the placement of membrane to prevent
- formation of long junctional epithelium
- Coronally repositioned flap
- Root conditioners
3. For Grade 3
- Tunneling
- Done in mandibular 1 molar due to better ac- accessibility
- It transforms Grades 2 to Grades 3 and 4
- Has increased risk of root caries
- So not used nowadays
- GTR
- Hemisection
4. For grade 4
- Extraction is done
Furcation Involvement Short Essays
Question 1. Root Resection.
Answer:
Root Resection Definition:
- It is the surgical removal of all or a portion of the root before or after endodontic treatment.
Root Resection Indication:
- Gingival recession
- Class 2 or 3 furcation
- Severe bone loss
Root Resection Contraindications:
1. Local:
- Poor oral hygiene
- Fused roots
- Endodontically untreated roots.
2. Systemic:
- Systemic diseases
Root Resection Technique:
Furcation Involvement Short Question And Answers
Question 1. Grade 3 furcation involvement
Answer:
furcation involvement Features:
- Complete inter-radicular bone loss
- No soft tissue loss
- Radiograph shows the radiolucent area between roots
furcation involvement Treatment:
- Tunneling
- Done in mandibular I molar due to better accessibility
- It transforms Grades 2 to Grade 3 and 4
- Has increased risk of root caries
- So not used nowadays
- GTR
- It involves the placement of membrane to prevent for- motion of long junctional epithelium
- Hemisection
- It is the surgical removal of the root with the associated part of the crown
Question 2. Tunneling
Answer:
- Done in mandibular 1 molar due to better accessibility
- It transforms Grades 2 to Grades 3 and 4
- Has increased risk of root caries
- So not used nowadays
Question 3. Hemisection
Answer:
- It is the surgical removal of the root with the associated part of the crown
- Commonly performed on mandibular molars with buc- cal or lingual class 2 or 3 furcation
Hemisection Technique:
Furcation Involvement Viva Voce
- The most commonly performed root resection is disto- the buccal root of the maxillary first molar
- Furcation is most commonly involved in mandibular molars
- Least commonly involved in maxillary 1st premolars
- The prognosis is poor if the furcation areas are in- involved in maxillary 1st premolars
- Hemisection and bicuspidisation are suitable for mandibular molars