Furcation Involvement

Furcation Involvement

Describe in brief write about furcation involvement and give in detail about treatment of Grade 2 furcation involvement and its prognosis.
Or
Define furcation. Classify furcation invasions. Describe in detail the treatment of Class 2 furcation involvement.
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Define and classify furcation involvement. Write various treatment methods for Grade 2 furcation defect.
Or
Define furcation involvement. Describe in detail classification, etiological factor and treatment of Grade 2 furcation involvement.
Or
Classify furcation involvement. Describe management of Grade 2 furcation involvement.
Or
Define and classify furcation involvement. Describe in detail about the management Grade 2 furcation involvement.
Or
Define and classify furcation involvement, discuss the management Class 2 furcation involvement.
Answer.

Management of Grade 2 furcation involvement

• Open flap debridement: If sufficient subgingival access is not possible with a closed approach, for furcated molars with deep lesions, then open flap debridement or modified Widman flap yields more effective plaque and calculus removal.
• Guided tissue regeneration: Organic or synthetic barrier membranes are used based on the principles of guided tissue regeneration.
• Bone grafting: The strong focus on bone formation as a prerequisite for new attachment formation has led to implantation of bone grafts or different types of bone substitutes into furcation defects. Among these are bone autografts, allografts, xenografts and alloplastic materials designed as either bone substitutes or biologic barriers.

Reconstructive and Regenerative Management in Shallow Grade 2 Involvement

• Autogenous, bone grafting, e.g. osseous coagulum, bone blend.
• Allograft, e.g. freeze dried bone allograft (FDBA), demineralized freeze dried bone allograft (DFDBA).
• Alloplasts—hydroxyapatite, tricalcium phosfate.
• Citric acid root conditioning with coronally positioned flap.
• Guided tissue regeneration and combination technique.

Prognosis of Grade 2 Furcation Involvement

In general teeth with furcation involvement have poor prognosis.

• Maxillary first premolar: It usually shows fusion of root and the function area may be located very much apically. The furcation opens mesiodistally. For these reasons, furcation involvement in maxillary first premolar has poor prognosis.
• Maxillary molars: Function may open, basally, medially and distally because of the presence of the three roots. Since access from proximal area is difficult for plaque control, prognosis of furcation involvement in maxillary molars is not good.
• Mandibular molars have two roots, placed mesially and distally and the function opens buccolingually. Roots are usually divergent. Prognosis is good.
  Following are the factors which are to be considered while projecting a prognosis of a tooth with Grade 2 furcation involvement:
• Extent of involvement
• Status of bone support
• Root separation
• Health of neighboring tooth
• Other factors are personal, psychological, sociological and financial considerations.