Periodontology Furcation Defects Flashcards

Furcation Defects Overview

• ILOs refer to competencies in conducting comprehensive periodontal examinations, including charting furcation involvement and managing associated lesions.
• A furcation defect is defined as a lesion located in the interadicular area of multi-rooted teeth.

Classification of Furcation Defects

• Hamp classification categorizes defects into classes:
  • Class I: Horizontal loss within 1/3 of tooth's width.
  • Class II: Bone loss varies; may require resective surgery or regenerative therapy depending on bone position.
  • Class III: Complete involvement; management varies based on keratinized width.

Treatment Modalities and Outcomes

• Class I defects are typically treated with non-surgical therapy.
• Class II defects with interproximal bone apical to the furcation may necessitate resective surgery (e.g., tunnel approaches, root amputation).
• Class II defects with interproximal bone coronal to the furcation can benefit from regenerative therapies like grafting materials and membranes.
• Class III defects may require resective surgery or apically positioned flaps based on keratinized tissue availability.

Regeneration and Healing Factors

• Periodontal regeneration involves forming new cementum, functional periodontal ligament, and alveolar bone.
• Successful regeneration is confirmed via histological analysis.
• Clinical factors impacting healing include selection of treatment site, patient compliance, gingival phenotype, recession, and initial pocket depth.

Prognostic Indicators for Treatment Success

• Good prognosis for class II defects linked to factors such as minimal gingival recession, narrow defects, and furcation entrance below the surrounding bone.
• Partial closure of defects (from Class II to I) is a realistic treatment goal.
• Regeneration of Class III defects is generally not feasible; focus remains on resective methods.

Therapies and Clinical Goals

• Therapeutic goals for periodontal treatment include achieving stability, infection control, reducing bleeding, and pocket reduction.
• A thorough radiographic evaluation, such as a full mouth periapical assessment, is crucial before any treatment.
• Proper management of associated factors, including maintenance of keratinized tissue, significantly influences treatment outcomes.

Clinical Health Definitions

• Pristine periodontal health: No bleeding on probing, normal sulcus depth, and controlled modifying factors.
• Gingivitis: Presence of bleeding on probing with normal sulcus depth and bone height.
• Periodontitis: Defined by depth of pockets and associated bleeding, with stability or remission categorized based on control of modifying factors.

Surgical Techniques and Considerations

• Surgical techniques like crown lengthening involve multi-phase approaches: incision, degranulation, and suturing, with attention to maintaining tissue integrity and aesthetics.
• Specific techniques, such as full thickness versus split thickness flaps in anterior and posterior teeth, cater to varying clinical presentations.
• Healing is influenced by factors like tissue phenotype, underlying bone quality, and periodontal fiber integrity.

Suture Management and Postoperative Care

• Suture removal is typically conducted 7-10 days post-surgery unless absorbable sutures are used; this timing aligns with stages of wound healing.
• Correct management of keratinized tissue around surgical sites is essential for optimal healing outcomes.