Furcations medium

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Questions and Answers

What is the primary goal of removing secondary local factors in dental care?

To prevent further attachment loss (correct)

To improve aesthetic appearance of teeth

To enhance patient comfort during treatment

To eliminate the need for routine cleanings

Which type of brush may be specifically beneficial for cleaning furcations?

Standard manual toothbrush

Interdental brush (correct)

Soft bristle toothbrush

Electric toothbrush with a round head

In terms of dental tools, what does the term 'power driven scalers' refer to?

Laser instruments used for tissue removal

Instruments with interchangeable working ends for better access (correct)

Manual tools designed for precision work

Traditional hand tools with fixed designs

What is an important factor to consider for effective oral hygiene advice tailored for furcation areas?

Patient's manual dexterity and current oral hygiene habits (D) Signup and view all the answers

How should furcations be monitored over time for effectiveness?

Through clinical photographs and radiographs (B) Signup and view all the answers

What is the significance of root divergence in dental morphology?

It impacts the access for cleaning around the roots. (C) Signup and view all the answers

Which of the following describes cervical enamel projections?

They extend beyond the cementoenamel junction. (A) Signup and view all the answers

How do enamel pearls affect dental health?

They are a plaque-retentive factor. (D) Signup and view all the answers

What challenges do enamel pearls pose for patients?

They complicate access for effective cleaning. (D) Signup and view all the answers

What is meant by interradicular dimensions in the context of root morphology?

The distance between diverging roots. (A) Signup and view all the answers

Why is it important to observe radio opacities in radiographs?

They can represent anatomical structures like enamel projections. (C) Signup and view all the answers

Which aspect of root length is most significant for dental treatment planning?

Longer root lengths improve stability of the tooth. (A) Signup and view all the answers

What is a furcation and why is it important in dentistry?

It's the area where a tooth's roots separate. (D) Signup and view all the answers

In assessing root morphology on radiographs, what measurement is most appropriate for root divergence?

Measured in mm. (D) Signup and view all the answers

What is a potential consequence of having teeth with furcations?

Difficulty in maintaining oral hygiene. (D) Signup and view all the answers

What distinguishes LL6 from LL7 in terms of radiographic furcations?

LL6 presents with more bone loss than LL7. (D) Signup and view all the answers

What does the furcation index grade indicate?

The amount of gingival recession and bone loss. (B) Signup and view all the answers

In Glickman Classification, which grade indicates that the probe can detect curvature but cannot enter the furcation space?

Grade I (B) Signup and view all the answers

What is the characteristic feature of Grade II in Glickman Classification?

Probe penetration into the furcation without complete passage. (B) Signup and view all the answers

What factors contribute to the grading of furcation severity?

Amount of bone loss and gingival recession. (C) Signup and view all the answers

Which furcation grade indicates that the area is not clinically visible but the probe passes completely through?

Grade III (A) Signup and view all the answers

Which of the following is NOT a factor considered in the furcation index?

Type of dental cement used. (D) Signup and view all the answers

What does the presence of inter-radicular bone loss indicate in furcation classification?

It implies a higher numerical index grade for furcation. (C) Signup and view all the answers

What initial step should be taken after identifying a furcation during an examination?

Assess the gingival tissues and their appearance. (A) Signup and view all the answers

Which probing tool is specifically mentioned for assessing furcations?

Nabers probe. (A) Signup and view all the answers

Why is it important to look at radiographs when assessing a furcation?

They help identify bone loss associated with the furcation. (B) Signup and view all the answers

What does the assessment of probing depths include?

Depth from the junctional epithelium to the gingival margin. (A) Signup and view all the answers

What are secondary local factors in the context of furcation assessment?

Individual patient circumstances that could complicate the condition. (C) Signup and view all the answers

When assessing gingival tissues, which of the following is NOT a sign you should look for?

Presence of calculus. (C) Signup and view all the answers

What should be recorded in addition to probing depths during a furcation assessment?

The extent of clinical attachment loss. (A) Signup and view all the answers

Which statement about using an OPG for assessing a furcation is true?

It can show changes in furcation conditions over time. (B) Signup and view all the answers

During the assessment of furcation issues, what should be compared against previous records?

Gingival appearance and probing measurements. (A) Signup and view all the answers

What can be a possible prognosis for a patient with furcation involvement?

The prognosis is limited but can be managed. (B) Signup and view all the answers

What represents a junction of the main pulp canals or the pulp chamber that communicates with the root surface?

Accessory canal (B) Signup and view all the answers

Which factor is NOT related to a tooth with furcation involvement?

Deep enamel caries (D) Signup and view all the answers

What is one of the primary objectives in treating furcation involvement?

To keep the area clean (B) Signup and view all the answers

Which of the following challenges do clinicians face when treating teeth with furcation involvement?

Complex treatment considerations (A) Signup and view all the answers

Why might a tooth with a furcation involvement require Root Canal Therapy (RCT)?

To treat an identified accessory canal (C) Signup and view all the answers

What type of radiograph is considered more stable for assessing furcations and bone loss?

Periapical radiograph (D) Signup and view all the answers

What can cause plaque buildup on the root surface around teeth with furcation involvement?

Overhanging restoration (C) Signup and view all the answers

Which of the following does NOT contribute to reduced prognosis for teeth with furcation involvement?

Effective plaque control (D) Signup and view all the answers

What is a potential outcome if an accessory canal is identified within the furcation area?

Need for Root Canal Therapy (RCT) (D) Signup and view all the answers

What should be removed to help maintain cleanliness in the furcation area?

Overhangs and calculus (B) Signup and view all the answers

Study Notes

Furcation Anatomy

Furcations present differently: LL6 and LL7 both have radiographic furcations but LL6 has more bone loss than LL7.
Inter-radicular bone loss present.

Furcations and Anatomical Features

Furcation index grade important to consider:
Root trunk length.
Root length.
Interradicular dimensions.
Cervical enamel projection and enamel pearls – can be found on radiographs.

Furcation Grading

Glickman classification
Grade 1: Probe can detect the curvature of the concavity between roots, but cannot enter the space.
Grade 2: Probe penetrates the furcation, but doesn’t pass through to the other side.
Grade 3: Probe passes completely through the furcation, but not clinically visible as soft tissue still fills the furcation defect.
Grade 4: Furcation is clinically visible, the opening is large enough to expose the inter-radicular area.

Radiographic & Anatomical Features

Radiographs can show root morphology, impacting treatment assessment.
Root divergence – degree of separation between roots – measured in mm.
Interradicular dimensions are the spaces between roots, which can be measured on radiographs.
Cervical enamel projections and enamel pearls can be identified on radiographs and when probing.
These can be difficult to clean and act as plaque retention areas which can increase risk of furcation involvement.

Furcation Impact on Patients

Patient aesthetics: Furcation involvement can be unsightly, particularly with a broad smile.
Challenging cleaning: Food packing, difficult to clean, sensitivity to exposed dentine, increased risk of root caries.
Prognosis: Reduced prognosis, but often manageable with good patient care and intervention.

Furcation Assessment

Assess gingival tissue: Look for signs of redness, swelling, inflammation, and suppuration
Probing depths – select the right probe and record recession.
Secondary local factors: Overhanging restorations, crown margins, calculus, accessory root canals.
Radiograph assessment is essential to identify inter-radicular bone loss.

Furcation Assessment Tools

Nabers probe: Curved, calibrated probe aiding accessibility for assessment.
Peri apical radiograph: preferred for assessing furcations and bone as they are easier to reproduce and compare over time.

Furcation Treatments

Primary goal: Prevent further attachment loss, maintain function of the tooth, and patient education on oral hygiene.
Secondary local factors: Remove plaque, overhangs , calculus, excess cement.
Specific oral hygiene advice: Utilize power flossing, interspace brushes, interdental brushes for access to the furcation.

Furcation Treatment Challenges

Complex treatments: Often require specialist intervention with challenging access for both clinician and patient.
Varied presentation: Different furcation involvement often needs specific, tailored treatment.

Furcation Treatment Considerations

Accessory canals: If identified, can often indicate the need for Root Canal Therapy (RCT).
Hand scalers: Specific curettes and power driven scalers are used to remove plaque and debris in the furcation.
Patient education: Reinforce the importance of thorough oral hygiene to prevent further deterioration.

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Description

This quiz covers the anatomy and grading of furcations in teeth. It includes the Glickman classification system for assessing furcation involvement and highlights important anatomical features and radiographic findings. Test your understanding of inter-radicular bone loss and the implications for dental health.