Diagnosis and Management of Furcation Lesions in Dogs – A Review

Abstract

The furcation is the anatomic area where the roots divide on a multirooted tooth. Periodontal disease causing alveolar bone loss can lead to furcation lesions of various stages. Once furcation involvement has occurred, the area can be more difficult to clean or treat due to the complex anatomy and morphology of furcations. Teeth with short root trunks, longer tooth roots, and roots with wide furcation entrance areas/degrees of separation and wide root divergence are considered better candidates for long term maintenance. Dog teeth possess many of these advantageous anatomic features compared to human teeth. Treatment options for teeth with furcation lesions include: closed debridement, open debridement, furcation plasty, tunneling, partial tooth or root resection, root separation (hemisection or trisection), regenerative therapies, or exodontia. There are many factors to consider in determining treatment options. The favorable and unfavorable characteristics for maintenance of teeth with furcation lesions are summarized. Home care and ongoing professional care are important aspects of periodontal disease control for any patient. Studies of systemic and local antibiotic therapies in human patients have not demonstrated reduction of furcation stages, and probiotic effects at furcation sites have not been specifically examined. Human review studies show that most molar teeth once deemed “hopeless” due to stage 3 furcation lesions can be maintained for at least 5 to 15 years with supportive periodontal therapy. Similar long term studies in dogs are needed to improve the evidence-based management of canine patients with furcation lesions.

Clinical success of guided tissue regeneration for treating vertical bone and furcation defects in dogs

“…This is not surprising, as again, with fewer walls, there is decreased stability of the bone graft to maintain space for clot stabilization and support the overlying barrier membrane without displacement. Zacher and Marretta ( 23 ) recently provided a comprehensive review of furcation lesions, including emphasizing characteristics of teeth with furcation lesions that are favorable for maintaining those teeth in the oral cavity. In the context of GTR, a wide furcation entrance area with wide root divergence may be favorable because these characteristics facilitate detection and access for treatment of furcation defects ( 23 ).…”

“…Zacher and Marretta ( 23 ) recently provided a comprehensive review of furcation lesions, including emphasizing characteristics of teeth with furcation lesions that are favorable for maintaining those teeth in the oral cavity. In the context of GTR, a wide furcation entrance area with wide root divergence may be favorable because these characteristics facilitate detection and access for treatment of furcation defects ( 23 ). The current study confirmed that GTR in F3 lesions is highly likely to fail.…”

Use of Ozone in Veterinary Dentistry as an Alternative to Conventional Antibiotics and Antiseptics

“…Concerning the severity of the pathological picture, each subject was assigned an increasing score, corresponding to a mild, intermediate, or advanced stage of periodontal disease. For classification of patients, the authors considered the gingival disease index [33] and the stages of furcation involvement and exposure index [34].…”

Periodontal Pocket Therapy Using a Class IV Dental Diode Laser in Dogs: A Retrospective Analysis

“…9,10 Older literature recommended the removal of cementum to smooth the tooth surface, however, current recommendations are to minimize the removal of this important normal tooth structure. 11,12 Two ways by which the periodontium heals diseased tissue are regeneration and repair. Regeneration is the restoration of normal anatomy.…”