Regeneration of class II furcation defects: determinants of increased success

Abstract

One of the most important indications for guided tissue regeneration (GTR) treatment is class II furcation lesion. However, periodontal regeneration of this type of defect, although possible, is not considered totally predictable, especially in terms of complete bone fill. Many factors may account for variability in the response to regenerative therapy in class II furcation. The purpose of this review is to assess the prognostic significance of factors related to the patient (smoking, stress, diabetes mellitus, acquired immunodeficiency syndrome and other acute and debilitating diseases, and the presence of multiple deep periodontal pockets), local factors (furcal anatomy, defect morphology, thickness of gingival tissue and tooth mobility), surgical treatment (infection control, bone replacement grafts combined with barriers or GTR alone, type of barrier and surgical technique), and postoperative period (plaque control, membrane exposure, membrane retrieval and a regular supportive periodontal care program) for successful of GTR in class II furcations.

Effect of Early Membrane Removal on the Treatment of Mandibular Class II Furcation Defects - A Controlled Clinical Trial with Re-entry after 12 Months

“…Histological and clinical studies have reported the potential of guided tissue regeneration (GTR) to regenerate periodontal ligament, cementum and alveolar bone (2,3), and the technical reasons for the success of this technique are well described in literature (4). In GTR, a barrier is inserted between the root surface and the gingival tissues to inhibit the apical migration of the epithelium and gingival connective tissue of the flap, allowing the granulation tissue derived from the periodontal ligament and osseous tissues to repopulate the space adjacent to the denuded root surface.…”

Mathematical analysis of furcation angle in extracted mandibular molars

“…Regeneration/healing of the involved furcation is complicated by the presence of developmental anamolies in the furcation areas such as cervical enamel projection, bifurcational ridge, root fusion, enamel pearls and root concavities. [27] However, there is still inadequate literature documenting the normal anatomy of the furcation. Existing anatomic classifications are based on two dimensional measurements that may not truly reflect the complexity of the furcation area.…”

Porous Titanium Granules in the Treatment of Mandibular Class II Furcation Defects: A Consecutive Case Series

“…A range of factors affect the response to periodontal reconstitutive therapy of furcation defects. Root and defect morphology may hinder adequate access and instrumentation of the roots 32 . The height and width of furcation defects have a significant impact on the potential for defect closure of furcations after regenerative therapy 33 .…”