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Revolutionizing Treatment of Class I Furcation Involvements

Discover how odontoplasty is changing the game in treating Class I furcation involvements, improving patient plaque control and oral health outcomes.

Class I furcation involvements are predictably treated through odontoplasty, in which the roof of the furcation is recontoured to eliminate the cul-de-sac that traps plaque in a vertical dimension.1,2 The newly established tooth contours must be carried onto the radicular surface to create a blended continuous morphology conducive to patient plaque control.

In the course of odontoplasty, any cementoenamel ­projections are eliminated (Figure 1 through Figure 4). If the tooth was not already planned for restoration, elimination of Class I furcation involvements through odontoplasty does not necessitate restoration of the reshaped area.

If restoration is planned, the tooth must be managed in a manner that combines various tooth preparation designs.1,2 Clinicians will choose their conventional crown preparation (whether it be chamfer, butt joint, or another approach) in all areas except where odontoplasty has been carried out.

Due to the reduced thickness of tooth structure following odontoplasty, this area will be treated with a feather edge or shallow chamfer to avoid undue compromise of intact tooth structure and resultant pulpal exposure. The casting is shaped to mimic these newly developed contours, with a flat emergence profile coming out of the sulcus for approximately 2 mm in the area of odontoplasty before smoothly transitioning to more conventional crown morphologies (Figure 5 and Figure 6).

References

  1. Rosenberg MM, Kay HB, Keough BE, Holt RL. Periodontol and Prosthetic Management for Advanced Cases. Chicago: Quintessence; 1988:247–298.
  2. Fugazzotto PA. Chapter 3 Treating the Periodontally Involved Furcation. In: Periodontal-Restorative Interrelationships: Ensuring Clinical Success. Wiley Blackwell: Ames, Iowa; 2011:89–113.

This information originally appeared in Brodsky A, Fugazzotto PA. Treatment approaches to periodontally furcated mandibular molars. Decisions in Dentistry. 2021;7(6)26–31.

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