Grade III furcation treatment in upper molars: Case series follow-up

| Posted in: Science Health Sciences Journals

Journal name: Journal of Indian Society of Periodontology
Original article title: Treatment of Grade III furcation involvement in upper molars: Case Series with 2–16-year follow-up
The Journal of Indian Society of Periodontology (JISP) publishes original scientific articles on periodontology (the study of supporting structures of teeth) and oral implantology. It is a bimonthly open-access journal with special issues for specific occasions.
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Original source:

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Author:

Camila Lopes Ferreira, Juliana de Fátima Pedroso, Victória Clara da Silva Lima, Tatiane Caroline de Souza Ramos, Antonio Braulino Melo Filho, Maria Aparecida Neves Jardini


Journal of Indian Society of Periodontology:

(A bimonthly open-access journal)

Full text available for: Treatment of Grade III furcation involvement in upper molars: Case Series with 2–16-year follow-up

Year: 2020 | Doi: 10.4103/jisp.jisp_251

Copyright (license): CC BY-NC-SA


Summary of article contents:

Introduction

This case series addresses the clinical decision-making between the preservation of Grade III furcation molars and implant replacement, particularly given the increasing accessibility and success rates of osseointegrated implants. The study presents the clinical and radiographic outcomes of 10 patients who underwent 13 root amputations for Grade III furcation involvement in maxillary molars, with follow-up extending to 16 years. It highlights the effectiveness of root amputation as a long-term solution, especially for patients facing various constraints that may limit their ability to receive implant therapy.

Preservation of Natural Dentition

One significant concept discussed in this research is the viability of root amputation as an effective treatment for Grade III furcation involvement. The case series demonstrates that with proper surgical intervention and ongoing supportive periodontal therapy (SPT), teeth with such advanced furcation lesions can be maintained in a healthy state for many years. The outcomes show marked improvements in clinical parameters like probing depth and bleeding on probing. Notably, the study asserts that the decision to maintain a tooth or proceed with extraction should consider various factors, including the patient's systemic health and financial circumstances, rather than focusing solely on cost-effectiveness.

Conclusion

In conclusion, despite the high success rates of dental implants, root amputation presents a feasible and effective treatment option for managing Grade III furcation involvement in upper molars. The presented case series emphasizes the potential for long-term preservation of natural dentition, advocating for resective procedures as a practical approach when traditional implant placement may not be achievable. Clinicians are urged to adopt a comprehensive view in treatment planning that prioritizes the patient's overall health and individual circumstances, reinforcing the importance of maintaining teeth whenever possible.

FAQ section (important questions/answers):

What is the focus of this case series on maxillary molars?

This case series presents clinical and radiographic outcomes of root amputations for Grade III furcation involvement in maxillary molars, demonstrating its effectiveness as a long-term treatment option.

Why might root amputation be preferred over implants for some patients?

Root amputation may be chosen when patients have local, systemic, or financial limitations that make implant placement difficult or impossible, as it provides an effective alternative for preserving natural teeth.

What were the main findings regarding periodontal health after treatment?

The results showed significant improvements in probing depth, bleeding on probing, and overall radiographic aspects, indicating that root amputation can maintain dental function over long-term follow-up.

How often should patients undergo supportive periodontal therapy (SPT)?

Patients should be enrolled in a periodic maintenance program with visits every three months or tailored to individual conditions, as this monitoring is essential for long-term dental health.

What factors influence the choice between root amputation and extraction?

Factors such as the degree of furcation involvement, remaining bone support, patient health, and cost considerations influence the decision to either preserve the tooth through amputation or opt for extraction.

Glossary definitions and references:

Scientific and Ayurvedic Glossary list for “Grade III furcation treatment in upper molars: Case series follow-up”. This list explains important keywords that occur in this article and links it to the glossary for a better understanding of that concept in the context of Ayurveda and other topics.

1) Table:
A table is crucial in the context of this study as it presents organized information regarding patient demographics and clinical parameters. Tables facilitate quick reference, enhancing the reader's ability to comprehend complex data such as bleeding on probing, probing depth, and follow-up findings, thus supporting the research conclusions effectively.

2) Bleeding:
Bleeding is a significant clinical parameter in periodontal assessment, indicative of tissue inflammation and health status. In the discussed case series, monitoring bleeding on probing (BOP) post-treatment helps evaluate the effectiveness of the root amputation procedure and the management of furcation involvement, essential for long-term dental health prognosis.

3) Disease:
Disease, particularly periodontal disease, is a focal point of the study. It causes attachment loss and furcation involvement, leading to treatment decisions like root amputation. Understanding the disease's progression and implications assists dentists in developing treatment plans to preserve natural dentition versus opting for implant replacements.

4) Relative:
Relative factors, such as a patient's systemic condition or financial constraints, significantly influence treatment choices between implant placement and preserving natural teeth. A relative evaluation of these factors helps clinicians determine the most practical and patient-centered approach, ensuring that treatment aligns with the patient's overall health and lifestyle.

5) Hygiene (Hygienic):
Hygiene plays a vital role in the success of periodontal therapies following interventions like root amputation. Proper oral hygiene practices reduce plaque accumulation and diminish the risk of post-treatment complications like peri-implantitis, essential for maintaining the health of remaining natural dentition and prolonging the longevity of periodontal treatment outcomes.

6) Male:
The gender distribution in the study, specifically the ratio of male to female patients, provides insights into epidemiological trends in periodontal disease and treatment outcomes. Understanding how gender might influence disease prevalence or treatment response can inform targeted approaches in periodontal therapy and patient education.

7) Science (Scientific):
Scientific evidence is foundational in determining the efficacy of various dental treatments, including root amputation versus implant therapy. A scientific approach ensures that treatment decisions are backed by data and research, enhancing clinical outcomes and providing a rationale for the chosen interventions based on long-term success metrics.

8) Rules:
Rules in a clinical context may refer to guidelines or protocols that govern treatment decisions and practices within dentistry. Adhering to established rules is crucial in ensuring consistent, evidence-based care and improving patient outcomes, particularly in complex cases like Grade III furcation involvement.

9) Study (Studying):
The study provides valuable insights into the long-term outcomes of root amputation for managing Grade III furcation involvement. By analyzing clinical data over an extended period, the study reinforces the viability of this treatment approach, contributing to the broader understanding of periodontal therapy effectiveness.

10) Inflammation:
Inflammation is an important physiological response related to periodontal disease. Monitoring signs of inflammation, such as bleeding on probing, is crucial for assessing the success of periodontal therapies. Effective management of inflammation can lead to improved clinical outcomes and longer retention of natural teeth.

11) Observation:
Observation in clinical practice is essential for monitoring the progress of treatments. Tracking changes in periodontal parameters like probing depths and bleeding over time allows clinicians to adjust care strategies accordingly, ensuring optimal patient outcomes and adherence to maintenance protocols after interventions such as root amputation.

12) Discussion:
The discussion section in research reports is critical for interpreting findings in the context of existing literature. It allows the authors to articulate the implications of their results, compare with previous studies, and provide a comprehensive overview of the challenges and successes of resective treatments for furcation involvement.

13) Antibiotic (Antibacterial):
Antibiotics are often prescribed as a prophylactic or therapeutic measure in dental treatments. In the context of root amputation, antibiotics help prevent postoperative infections, which is crucial for healing and ensuring the success of the procedure. Effective antibiotic management plays a pivotal role in patient care.

14) Knowledge:
Knowledge, particularly about periodontal disease, treatment options, and patient management, is paramount for dental professionals. It underpins the ability to make informed decisions regarding treatment approaches, enhances clinical skills, and improves communication with patients about their condition and the implications of various treatment alternatives.

15) Reason:
Reasoning in clinical practice involves evaluating the benefits and drawbacks of different treatment options based on the patient's specific circumstances. Reasonable decision-making is essential for selecting appropriate therapies that align with patient needs, expectations, and overall health, guiding towards the most effective treatment outcomes.

16) Desire:
Desire refers to patients' preferences regarding their dental treatment. Understanding a patient's desire to retain natural teeth versus opting for implants is essential for treatment planning. It influences clinician-patient communication and shared decision-making, ensuring that the care provided aligns with patient values and goals.

17) Visit:
Visit frequency is crucial in periodontal maintenance therapy following interventions like root amputation. Regular visits enable consistent monitoring of oral health, allowing for timely interventions and adjustments to treatment protocols as necessary, ultimately enhancing patient outcomes and promoting long-term success of the initial treatment.

Other Health Sciences Concepts:

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Discover the significance of concepts within the article: ‘Grade III furcation treatment in upper molars: Case series follow-up’. Further sources in the context of Health Sciences might help you critically compare this page with similair documents:

Treatment modalities, Restorative treatment, Demographic Data, Surgical Procedure, Periodontitis, Chronic periodontitis, Dental extraction, Supportive periodontal therapy, Clinical parameter, Furcation involvement, Periodontal attachment loss, Osseointegrated implant, Maxillary molars.

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