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Overcoming Challenges in Class II Furcation Involvement

Learn how odontoplasty and regenerative surgery play pivotal roles in managing Class II furcation involvement.

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When presented with a Class II furcation, the team must assess a number of treatment options. Odontoplasty cannot be employed to eliminate the “roof” of the periodontally involved furcation, as the resultant tooth contours would be characterized by a deep notch that would retain plaque.

If the tooth has a favorable prognosis with treatment, a combination of odontoplasty to reduce the horizontal component of the furcation, followed by regenerative surgery or root resection, can be completed.1 If the prognosis is unfavorable with these methods, tooth removal and replacement, must be employed (Figure 1 through Figure 3).

If the vertical component of the furcation involvement, in combination with the overall treatment plan, warrant attempts at maintaining a tooth with a Class II furcation involvement, odontoplasty is performed to the depth which will be employed to eliminate a Class I furcation.

Regenerative periodontal therapy is then carried out in the reduced (and thus more predictable) furcation defect. The same restorative principles regarding appropriate preparation designs are followed, as in the instance of eliminating a Class I furcation via odontoplasty.

Reference

  1. Fugazzotto PA. Decisions Making at the Time of Treatment of Furcated Mandibular Molars: Roles of Resective, Regenerative, and Implant Therapies. In: Implant and Regenerative Therapy in Dentistry: A Guide to Decision Making. Wiley Blackwell: Ames, Iowa: 2009:248.

This information originally appeared in Brodsky A, Fugazzotto PA. Treatment approaches to periodontally furcated mandibular molars. Decisions in Dentistry. 2021;7(6)26–31.

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