ABSTRACT
Predicting the prognosis of molars that have experienced furcation invasion, is often a frustrating experience to the dental clinician and disappointing report to the patient involved. Although multiple treatment modalities have been attempted to retain teeth with severe furcation invasion, clinical success has not been predictable. A case report involving the use of glass ionomer cement (GIC) as an occlusive barrier in the management of Class III furcation defect involving mandibular first molar is presented. A literature review on the subject matter was conducted using Medline, Google search engines, and manual library search. GIC restoration of Class III furcation invasion gives a satisfactory result. Surgical and nonsurgical treatment options are available for the management of the condition. GIC as an occlusive barrier in Class III furcation invasion is an economical and less invasive treatment option. It also makes home care easy for the patient.
Subject(s)
Adult , Bone Regeneration/physiology , Bone Substitutes/therapeutic use , Dental Scaling , Female , Follow-Up Studies , Furcation Defects/classification , Furcation Defects/surgery , Glass Ionomer Cements/therapeutic use , Humans , Mandibular Diseases/surgery , Molar/pathology , Resin Cements/therapeutic use , Root Planing , Subgingival Curettage , Surgical FlapsABSTRACT
Objective : To use the periosteum as a barrier in treatment of buccal Grade II furcation defects of lower molars. Materials and Methods : This technique was performed on 12 patients with bilateral buccal Grade II furcation defects of lower molars. On a random basis, one furcation defect of each pair was selected for the control group and other for the experimental group. Debridement was done in the defect area in both groups. In the control group, after debridement, mucoperiosteal flap was sutured back. In the experimental group, after reflection of the mucoperiosteal flap, a portion of the periosteum along with a layer of connective tissue (periosteal membrane) was incised and mobilized in the defect area for defect coverage as a barrier, and then the periosteal membrane and mucoperiosteal flap were fixed with suture, respectively. Horizontal dimension of the furcation defect was the primary outcome measure. Gingival index, probing attachment level (PAL), and vertical dimension of furcation defect were the secondary outcome measures. Clinical parameters were registered at baseline and at 6 months. Results : Every clinical parameter was improved by surgery. Significant gain in PAL as well as horizontal and vertical dimensions of the furcation defects was found. Conclusion: This periosteum displacement technique is effective for the treatment of buccal Grade II furcation defects of lower molars.
Subject(s)
Adult , Connective Tissue/transplantation , Debridement/methods , Follow-Up Studies , Furcation Defects/classification , Furcation Defects/surgery , Guided Tissue Regeneration, Periodontal/methods , Humans , Male , Mandibular Diseases/surgery , Middle Aged , Molar/surgery , Mouth Mucosa/surgery , Periodontal Attachment Loss/classification , Periodontal Attachment Loss/surgery , Periodontal Index , Periodontal Pocket/classification , Periodontal Pocket/surgery , Periosteum/transplantation , Surgical Flaps , Suture Techniques , Treatment OutcomeABSTRACT
As lesões de bifurcação classe II constituem uma das principais indicações para a técnica de regeneração tecidual guiada. Entretanto, a regeneração periodontal deste tipo de defeito ósseo, embora possível, não é considerada um resultado totalmente previsível, principalmente em termos de completo preenchimento ósseo. Muitos fatores podem explicar a variabilidade nos resultados do tratamento regenerativo nas lesões de bifurcação classe II. O objetivo desta revisão de literatura foi avaliar o significado de fatores relacionados ao paciente (fumo, estresse, diabetes mellitus, AIDS e outras doenças agudas e debilitantes, e presença de bolsas periodontais em outros sítios da boca), às condições locais (anatomia da furca, morfologia do defeito, espessura gengival e mobilidade dentária), ao tratamento cirúrgico (controle de infecção, utilização de materiais para preenchimento ósseo, tipo de membrana e técnica cirúrgica) e ao período pós-operatório (controle de placa, exposição e remoção das membranas e terapia periodontal de suporte) para o sucesso da RTG no tratamento das lesões de bifurcação classe II.
Subject(s)
Humans , Furcation Defects/surgery , Guided Tissue Regeneration, Periodontal , Chronic Disease , Furcation Defects/classification , Furcation Defects/pathology , Guided Tissue Regeneration, Periodontal/classification , Guided Tissue Regeneration, Periodontal/methods , Postoperative Complications , Periodontium/physiopathology , Risk Factors , Regeneration/physiology , Treatment OutcomeSubject(s)
Furcation Defects/diagnosis , Furcation Defects/etiology , Evidence-Based Medicine , Bicuspid , Furcation Defects/surgery , Furcation Defects/classification , Dental Occlusion, Traumatic , Dental Pulp Diseases , Freeze Drying/methods , Molar , Tooth Root/anatomy & histology , Tooth Root/surgery , Tooth Root/injuries , Guided Tissue Regeneration , Terminology , Bone Transplantation/methodsABSTRACT
The management of furcation defects remains a challenge in periodontal therapy, Traditionally, furcation therapy involved scaling, rootplaning, furcation plasty and resective techniques. The purpose of this study was to clinically evaluate the potential of guided tissue regeneration in the treatment of mandibular molar grade II furcations using a nonresorbable barrier, TefGen-GTR and compare it with open flap debridement alone. Ten patients with similar bilateral grade II furcation lesions participated in the study. TefGen-GTR was placed in the experimental sites while the contralateral sites served as controls. Treatment effects were evaluated at six months reentry. Both groups showed gain in vertical and horizontal open probing attachment and defect depth reduction when compared to baseline values, with experimental sites showing statistically significant improvement over the controls. The results suggest that the nonresorbable Teflon barrier, TefGen-GTR, may be used as an alternative for treatment of grade II furcation invasions.
Subject(s)
Adult , Alveolar Bone Loss/classification , Debridement , Dental Scaling , Follow-Up Studies , Furcation Defects/classification , Guided Tissue Regeneration, Periodontal/instrumentation , Humans , Mandible , Matched-Pair Analysis , Membranes, Artificial , Middle Aged , Molar/pathology , Periodontal Attachment Loss/classification , Periodontal Pocket/classification , Polytetrafluoroethylene , Root Planing , Statistics as Topic , Surgical FlapsABSTRACT
La afeccion periodontal interradicular debe recibir un tratamiento conservador, quirurgico y/o protetico segun la profundidad de la lesion. Ademas de la placa bacteriana, puede ser agravante la posicion del diente, la oclusion, la anatomia, etc. En principio conviene intenetar una terapeutica conservadora, pero en casos mas avanzados la solucion es quirurgica o quirurgico-protetica con seccionamiento de la pieza dentaria. Se presentan algunos casos caracteristicos y su tratamiento, que debe ser controlado periodicamente