comparative prospective clinical study of resective and inductive treatment of furcated molars. Root resectionversus guided tissue regeneration

ABSTRACT

This article reports two clinical modalities of treatment for class II B/C furcation defects. Twenty two mandibular molar teeth demonstrating class II furcation [with severe bone loss around one root] were included in the study. The therapy selected entailed scaling and root planning, removal of any carious lesions or leaking restorations .Out of the twenty two furcation defects eleven were managed with hemisection/root resection after reciving proper endodontic treatment prior the resection. The other furcation defects were treated with regenerative therapy -tricalcium phosphate alloplast was packed into the defect followed by collagen membrane placement over the graft. The results revealed significant improvement as regard all the recorded clinical parameters along the non-resected root in root resection group [RR]. With regenerative therapy promising clinical results were achieved in guided tissue regeneration and graft group[GTR and graft] with significant reduction in pocket depth and gain inclinical attachment level. Re.-entery procedure at 9 months showed favourable osseous changes with insignificant difference between the two groups. The only clinical parameter in which significant difference was demonstrated between groups was the gingival recession. Marked gingival recession was detected in RR group. Since long term prognosis of resected teeth is problematic and progressive gingival recession complicate the procedure, an alternative treatment modality has to be evaluated and compared to the resective techniques. In conclusion, the results of the present study showed that root resection is a good therapeutic modality for saving teeth but if the regenerative therapy is rendered, periodontally involved molars can be maintained and serve successfully instead of utilizing resective techniques So specific periodontal .endodontic and restorative factors must be taken into consideration whenever root resection has been attempt to be performed