Bicuspidization

[Drsumitra]

 A study evaluated the survival rate and incidence of complications of multirooted teeth with furcation involvement that had received perio­dontal treatment. It involved a Med­line search and handsearching of the International Journal of Perio­dontics and Res­torative Den­tistry, Journal of Clinical Perio­don­tol­ogy, Journal of Perio­dontal Re­search, and Journal of Perio­dontology, as well as reference lists of publications selected. Studies were screened and quality assessed independently by 2 reviewers. Review articles, case reports, studies less than 5 years in duration, and studies that did not provide information on tooth survival or furcation in­volvement were excluded. The 2 reviewed independently ab­stracted the data. Owing to the heterogeneity of the data, a meta-analysis could not be performed. A qualitative synthesis was conducted grouping the studies into the following areas: nonsurgical furcation therapy; surgical therapy not involving tooth structures; tunnelling surgical resective therapy (eg, root resection and/ or root separation); and guided tissue re­generation (GTR) and grafting procedures. The study found 22 publications that met the inclusion criteria. The survival rate of molars treated nonsurgically was > 90% after 5 to 9 years. The corresponding values for the different surgical procedures were: surgical therapy, 43.1% to 96% (observation period, 5 to 53 years); tunnel­ling procedures, 42.9% to 92.9% (observation period, 5 to 8 years); surgical resective procedures including amputation(s) and hemisections, 62% to 100% (observation period, 5 to 13 years); and GTR, 83.3% to 100% (observation period, 5 to 12 years). The most frequent complications included caries in the furcation area after tunnelling procedures and root fractures after root-resective procedures. It concluded that good long-term survival rates (up to 100%) of multirooted teeth with furcation involvement were ob­tained following various therapeutic approaches. Initial furcation involvement (degree 1) could be successfully managed by nonsurgical mechanical debridement. Vertical root fractures and en­dodontic failures were the most frequent complications ob­served following resective pro­cedures.