The Prognosis of Tunnel Preparations in Treatment of Class III Furcations

Abstract

The present study evaluated the long-term prognosis of tunnel preparations performed in a large number of teeth with advanced periodontal furcation defects. One hundred seven (107) patients, in which 156 teeth had been treated by tunnel preparations, were recalled for an evaluation, which was based on a questionnaire, a clinical examination, and radiographs; 102 patients attended (149 teeth = 95%). The mean observation time per tooth was 37.5 months (range 10 to 107 months). The results showed that 10 teeth (6.7%) had been extracted and 7 teeth (4.7%) hemisected. The indication for 12 of these extractions or hemisections was root caries. Among the remaining 132 teeth, 23 (15.4%) showed initial or established caries. There was no relationship between caries development and length of the observation time. Thus, approximately 75% of the teeth were still caries-free and in function. The findings demonstrated that tunnel preparations have a considerably better prognosis than previously reported and should be considered a valid treatment alternative.

Molar root anatomy and management of furcation defects

“…3 of the 7 teeth had a greater than 3 mm probing depth, and 4 of 7 (57%) developed root caries that led to the extraction of 3 teeth (43%). More favorable results were reported by Helldèn et al (1989). In an evaluation of 149 molars with grade III furcation involvement treated by tunneling, they reported that the majority of probing depths were <3 mm, after an average of 37.5 months.…”

Periodontal Probing Versus Radiographs for the Diagnosis of Furcation Involvement

“…The management of molars with furcation involvement (FI) represents one of the major challenges in clinical periodontology 1,2 . Treatment of periodontally diseased molars with no FI or FI Class I 1 may be managed by root debridement alone, 3 whereas advanced FI (Class II or III 1 ) requires invasive, in some cases resective, techniques 4‐6 . FI Class II 1 of mandibular molars as well as of buccal furcations in maxillary molars may be successfully treated by regenerative procedures 7 .…”

Treatment of grade III furcation lesion by tunneling in a smoker patient: Clinical Case Report

“…Although the tunneling technique provides greater access to cleansing of the furcation region, on the other hand, there is a greater risk of caries formation in the root. In fact, a study evaluating the incidence of caries in molars that underwent tunneling therapy showed that after 37.5 months, 24% of 149 treated teeth had carious lesions in the furcation region 15 . Another possible complication from the tunneling technique is the occurrence of dental hypersensitivity since this surgery exposes a large number of dentinal tubules and accessory canals with the oral medium 16 .…”