Comparison of conventional treatment methods in class III furcation defects

The involvement of furcation region related to the alveolar bone loss is seen frequently in clinical practice. The extraction of teeth with furcation involvement had been considered as the only treatment choice during several decades. According to the epidemiological and clinical studies multi-rooted teeth was lost earliest and the restorative applications were done to these posterior regions where multi rooted teeth were extracted. Recently the extended knowledge in furcation pathology and periodontal pocket, the enhanced importance of preventive dentistry and the role of multi-rooted teeth in maintaining the oral and systemical health lead the clinicians to give importance in the treatment and preservation of these teeth although the treatment requires experience and skill instead of early loss of multi-rooted teeth which have fundamental role in mastication and digestion function, the need of preserving these teeth in dentition lead us to update the two conventional treatment methods in the era of regeneration therapy which involves the use of graft materials since 1980. For this aim, the mandibular first and/or second molar teeth which have symmetrical Class III furcation defects of patients diagnosed with adult periodontitis were treated with either tunnel operation (the enhancement of furcation entrance) or bicuspidisation (the elimination of the furcation) and these conventional therapy methods were evaluated separetly and compared each other. The material of the present clinical study was comprised of 22 mandibular first molar and/or second molar teeth of nine patients who had at least two symmetrical Class III furcation defects diagnosed according to the standardized radiographical and clinicalexaminations. 11 out of 22 Class III furcation defects were randomly treated with bicuspidisation and 11 of them were treated with tunnel operation. By that way two groups were formed. The pocket depth, gingival index, plaque index measurements from whole mouth were performed at baseline, and postoperative 12 months. Besides this, pocket depth, gingival index, plaque index and the mobility records were obtained from the treated teeth at baseline, postoperative 6th months. The standardised radiographs were taken at baseline, postoperative 6th month and 12th months. The mean of pocket depth, plaque index and gingival indices of both maxillary and mandibular teeth obtained from whole mouth were decreased at 12th months postoperatively compared to baseline measurements. While the pocket depth of the patients treated with tunnel operation was found to be increased at postoperative 6th months compared with the patients treated with bicuspidisation. There were not any statistical significant differences in Gl, PI, mobility and furcation area between these two groups. At postoperative 12 months in both groups, there were not any statistical significant differences in PD, Gl, PI, mobility and furcation area.