FURCATION - PowerPoint PPT Presentation

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FURCATION

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... root morphology) local developmental anomalies (e.g., cervical enamel ... the furcation display the defect as a radiolucent area Grade IV ... – PowerPoint PPT presentation

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Title: FURCATION


1
FURCATION
2
DEFFINITION
  • The furcation is an area of complex anatomic
    morphology, that may be difficult or impossible
    to debride by routine periodontal instrumentation.

3
Etiologic Factors
  • bacterial plaque
  • local anatomic factors (e.g., root trunk length,
    root morphology)
  • local developmental anomalies (e.g., cervical
    enamel projections)

4
Diagnosis
  • clinical examination
  • Careful probing (Nabors probe)
  • Transgingival sounding

5
Local Anatomic Factors
  • Root trunk length
  • Root length
  • Root form
  • Interradicular dimension
  • Anatomy of furcation
  • Cervical enamel projections

6
Root Trunk Length
  • The distance from the cementoenamel junction to
    the entrance of the furcation can vary
    extensively

7
Anatomy of the Bony Lesions
  • Pattern of Attachment Loss
  • Horizontal bone loss can expose the
    furcation as thin facial/lingual plates of bone
  • The treatment response in deep, multiwalled
    bony defects is different from that in areas of
    horizontal bone loss.
  • Other Dental Findings

8
Indices of Furcation Involvement
  • Glickman's classification

9
Grade I
  • incipient or early stage
  • pocket is suprabony
  • primarily affects the soft tissues
  • Early bone loss
  • radiographic changes

10
Grade II
  • essentially a cul-de-sac
  • definite horizontal component
  • Radiographs may or may not depict the furcation
    involvement

11
Grade III
  • bone is not attached to the dome of the furcation
  • periodontal probe completely through the
    furcation
  • display the defect as a radiolucent area

12
Grade IV
  • interdental bone is destroyed
  • soft tissues have receded apically
  • furcation opening is clinically visible

13
Other Classification Indices
  • Hamp et al modified a three-stage classification
    system
  • Easley and Drennan and Tarnow and Fletcher
  • A
    B C
  • vertical depth- 1-3mm 4-6mm
    gt7mm
  • Furcations-IA,IB,IC
  • IIA,IIB,IIC
  • IIIA,IIIB,IIIC

14
Treatment
  • objectives of furcation therapy
  • (1) facilitate maintenance
  • (2) prevent further attachment loss
  • (3) obliterate the furcation defects as a
    periodontal maintenance problem

15
Therapeutic Classes of Furcation Defects
  • Class I Early Defects
  • oral hygiene, scaling,
    and root planing
  • Class II
  • Localized flap procedures with odontoplasty,
    osteoplasty, and ostectomy.
  • GTR(Guided tissue regeneration)
  • Classes II to IV Advanced Defects
  • Periodontal surgery, endodontic therapy, and
    restoration of the tooth may be required to
    retain the tooth.

16
Nonsurgical Therapy
Oral Hygiene Procedures
Scaling and Root Planing
17
Surgical Therapy
  • Osseous Resection
  • Regeneration(GTR)
  • Root Resection
  • Hemesection
  • Extraction
  • Dental Implants

18
Root ResectionProcedure
19
Hemisection Procedure
20
Dental Implants
21
MCQ-1
  • Which of the following author have described
    classification system that consider both
    horizontal and vertical attachment loss in the
    extent of furcation involvement
  • (a)Glickman
  • (b)Hamp
  • (c) Nyman
  • (d)Tarnow

22
MCQ-2
  • The furcation lesion have definite horizontal
    component,radiographs may or may not depict the
    furcation involvement
  • (a)Grade I
  • (b)Grade II
  • (c)Grade III
  • (d)Grade IV

23
MCQ-3
  • Which is the best treatment modality of isolated
    deep class II furcations
  • (a)Scaling and Rootplaning
  • (b)Odantoplasty and Osteoplasty
  • (c)Flap debridement with osteoplasty and
    odantoplasty
  • (d) Rootresection and Hemisection

24
MCQ-4
  • Which of the following have good candidates for
    regeneration procedure
  • (a)Class I furcation
  • (b)Class II furcaton
  • (c)Class III furcation
  • (d)Class IV furcation

25
MCQ-5
  • Which of the following probe is used for the
    diagnosis of furcation defects
  • (a)U.N.C Probe
  • (b)WHO Probe
  • (c)CPITN Probe
  • (d)Nabers Probe
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