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Periodontal surgery in furcation-involved maxillary molars revisited-an introduction of guidelines for comprehensive treatment

Walter, Clemens and Weiger, Roland and Zitzmann, Nicola Ursula. (2011) Periodontal surgery in furcation-involved maxillary molars revisited-an introduction of guidelines for comprehensive treatment. Clinical oral investigations, Vol. 15, no. 1. pp. 9-20.

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Official URL: http://edoc.unibas.ch/dok/A6003317

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Abstract

Maxillary molars with interradicular loss of periodontal tissue have an increased risk of additional attachment loss with an impaired long-term prognosis. Since accurate clinical analysis of furcation involvement is not feasible due to limited access, morphological variations and measurement errors, additional diagnostics, e.g., with cone-beam computed tomography, may be required. Surgical treatment options have graduated from a less invasive approach, i.e., keeping as much periodontal attachment as possible, to a more invasive approach: (1) open flap debridement with/without gingivectomy or apically repositioned flap and/or tunnelling; (2) root separation; (3) amputation/trisection of a root (with/without root separation or tunnel preparation); (4) amputation/trisection of two roots; and (5) extraction of the entire tooth. Tunnelling is indicated when the degree of root separation allows for opening of the interradicular region. Alternatively, root separation is performed particularly in root-canal treated teeth with reduced coronal tooth substance requiring crown restorations. As soon as the attachment of one or two roots in maxillary molars is severely reduced, root removal is indicated and performed either as amputation or trisection including the corresponding part of the clinical crown. While the indication for regenerative measures in maxillary molars with furcation involvement is very limited, extraction and replacement with implants is restricted, particularly in sites requiring complex alveolar ridge augmentation and sinus elevation. A systematic approach for decision making in furcation-involved maxillary molars is described in this overview, including what constitutes accurate diagnosis and what indications there are for the different surgical periodontal treatment options.
Faculties and Departments:03 Faculty of Medicine > Departement Zahnmedizin > Klinik Zahnerhaltung
03 Faculty of Medicine > Departement Zahnmedizin > Klinik Zahnerhaltung > Zahnerhaltung (Weiger)
UniBasel Contributors:Zitzmann, Nicola and Weiger, Roland and Walter, Clemens
Item Type:Article, refereed
Article Subtype:Research Article
Bibsysno:Link to catalogue
Publisher:Springer
ISSN:1432-6981
Note:Publication type according to Uni Basel Research Database: Journal article
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Last Modified:27 Mar 2014 13:13
Deposited On:27 Mar 2014 13:13

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