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Results for “Furcation Defects”

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PubMed2002

Tooth loss and pocket probing depths in compliant periodontally treated patients: a retrospective analysis.

BACKGROUND/AIMS: This retrospective study determined the treatment outcomes of 142 compliant periodontal patients observed for at least 10 years at the University of Kiel. All patients had been treated for moderate to advanced periodontitis and regularly received supportive periodontal therapy (SPT). METHODS: Patient- and tooth-related variables [tooth loss and pocket probing depth (PPD)] were analysed. RESULTS: Of a total of 3353 teeth, 167 were extracted during active treatment and 99 during SPT, mainly for periodontal reasons. Forty-five per cent of the patients did not lose any teeth during 11.7 years of observation. Thirty-seven per cent underwent extractions during active treatment or SPT, 18% both during active periodontal therapy and SPT. Mean tooth loss per patient was 0.07 teeth/year during SPT. Mobility, furcation involvement, smoking, and prescription antibiotics had a negative impact on prognosis. Intraindividual differences in PPD were significant between single- and multirooted teeth with initial PPD > or = 4 mm at baseline, following active treatment and at the end of SPT, and between firm and mobile teeth at baseline. Interindividual differences in mean PPD were only significant between smokers and non-smokers at the end of the observation period. CONCLUSIONS: Long-term maintenance of our patients was effective. Periodontal disease represented the major cause of tooth loss in a minority of the population.

Adult↗
PubMed2002

A systematic review on the use of residual probing depth, bleeding on probing and furcation status following initial periodontal therapy to predict further attachment and tooth loss.

BACKGROUND: Chronic periodontitis affects many adults. Initial cause related therapy (ICRT) is aimed at elimination of factors causing disease progression. OBJECTIVES: To use a systematic review process of peer reviewed publications to assess the predictive value of residual probing depths (PD), bleeding on probing (BOP) and furcation involvement (FI) in determining further loss of attachment and tooth loss following ICRT. MATERIAL AND METHODS: An electronic search of the Cochrane Oral Health Group specialized register, MEDLINE and EMBASE, was performed using specific search terms to identify studies assessing the predictive value of residual probing depths (PD), bleeding on probing (BOP) and furcation involvement (FI) in determining further loss of attachment and tooth loss following ICRT. RESULTS: The searches resulted in 941 uniquely identified studies. Titles and abstracts were then independently screened by two reviewers (S.R. and G.R.P.) to identify publications that met specific inclusion criteria. The agreement between the reviewers was assessed and statistical analysis failed to demonstrate a difference between the two reviewers (kappa-value: 0.94, P = 0.003). Detailed review of 47 included publications resulted in acceptance of one publication which utilized data based on patient as unit of observation. This study included 16 subjects over 42 months demonstrating that residual probing depths are predictive of further disease progression whereas persisting bleeding on probing are not. CONCLUSIONS: Data based on one study suggest that residual probing depths are predictive of further disease progression. The implications for carefully designed multicentre randomized clinical control trials are many.

Adult↗
PubMed2003

Treatment of combined endodontic-periodontic lesions by intentional replantation and application of hydroxyapatites.

A case of combined endodontic-periodontic lesions on a mandibular first molar was treated by intentional replantation and application of hydroxyapatites. Four months after the surgery, a porcelain-mental full crown restoration was completed. The 15-month follow-up examination showed that the tooth was clinically and radiographically healthy and functioned well.

Adolescent↗
PubMed2005

A comparison of two radiographic assessment protocols for patients with periodontal disease.

OBJECTIVE: Radiographic assessment of patients with generalised severe periodontitis may be undertaken with a panoramic view and supplementary periapicals. The purpose of this study was to estimate the effective radiation dose from this form of radiographic assessment, and to compare it with an estimate of the dose from a series of periapicals of all the affected teeth. DESIGN: Cross-sectional observational study. SETTING: Departments of Periodontology and Radiology, Glasgow Dental Hospital and School. METHOD: Fifty consecutive patients [were recruited] with sufficiently widespread advanced periodontitis to require at least seven periapical radiographs. [Following new local guidelines, a panoramic view was taken.] The adequacy of the image of every affected tooth and the number of supplementary periapicals required was determined by a panel of four examiners who also calculated the number of periapicals which would have been taken if panoramic radiography had not been available. An effective dose of 0.001 mSv for one periapical and 0.007 mSv for a panoramic view was assumed. RESULTS: The panoramic-plus-periapicals approach delivered an estimated additional effective dose to 86% of patients, in the order of 0.001-0.007 mSv. CONCLUSIONS: Within the parameters of this investigation, the anticipated effective radiation dose from a series of periapical radiographs of all selected teeth would, for the great majority of patients, have been less than the dose from a panoramic-plus-periapicals approach.

Adult↗
PubMed1999

Interexaminer reliability of the assessment of clinical furcation parameters as related to different probes.

The aim of this study was to investigate the interexaminer reliability of the assessment of clinical furcation diagnosis. Horizontal attachment level (PAL-H) measurements were obtained by 3 examiners in 6 molars in each of 10 patients with advanced periodontitis. In each patient, 3 molars were examined using a 3 mm incrementally marked Nabers probe, and 3 molars were examined using a pressure-calibrated plastic probe (TPS). Assignment of the probe was random, and the schedule of examiners was changed for each patient. Clinical assessments were validated by intrasurgical measurements in 6 patients. Sixty molars with 152 furcations were investigated. Multifactorial analysis of variance revealed that PAL-H measurements were significantly influenced by examiner and furcation location, whereas type of probe and schedule of examination had no influence. The overall intraclass correlation coefficient was r = 0.695. The difference between clinical and intrasurgical PAL-H assessment was influenced by examiner and location but not by type of probe. Approximately 70% of the total variance of PAL-H measurements was due to the variance of true values, whereas 30% of the variance may be explained by interexaminer and intraexaminer variance. The pressure-calibrated TPS probe failed to increase the interexaminer reliability of PAL-H measurements when compared to a Nabers probe.

Adolescent↗
PubMed2002

Diagnosing periapical lesions--disagreement and borderline cases.

AIM: The aim of this paper is to present a selection of disagreement and borderline cases from a methodological study on the radiographic diagnosis of periapical disease. METHODOLOGY: Thirty-two roots, 12% of the material in an earlier study, were subjected to joint discussion because of diagnostic problems. The aim was consensus. Six cases representing different teeth/roots illustrating typical problems are presented. RESULTS: The varying morphology of apical areas and varying density of surrounding bone present a number of challenges. Even so, the joint discussion resulted in an agreement for all the cases. Twenty-five diagnoses were established and seven cases were not diagnosed owing to substandard radiographs. CONCLUSION: A detailed analysis of the periodontal ligament space, the lamina dura, trabecular pattern and bone marrow spaces is mandatory for the radiographic diagnosis of periapical disease

Alveolar Bone Loss↗
PubMed2000

Case 10.

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Alveolar Bone Loss↗
PubMed2002

Sealing ability of mineral trioxide aggregate and super-EBA when used as furcation repair materials: a longitudinal study.

Immediate sealing of furcation perforations enhances the repair process. The purpose of this study was to longitudinally compare the ability of mineral trioxide aggregate (MTA) and Super-EBA to seal furcation perforations. Fifty-one extracted human maxillary molars were decoronated 3 mm above the CEJ, and the roots were amputated 3 mm below the furcation. A #2 high-speed round bur was used to perforate the center of the furcations. The canals were obturated with gutta-percha, and the root ends were sealed with C&B Metabond. Three experimental groups of 15 teeth each were restored with MTA, Super-EBA, or a combination of MTA in the perforation and a Super-EBA dome on the pulpal floor. Six teeth served as controls. Each tooth was affixed to a fluid filtration device and subjected to a pressure of 20 cm H2O. The integrity of the perforation seal was evaluated initially at 30 min for the Super-EBA and the combination groups and at 4 h for the MTA group. Additional measurements were then made at 24 h, 1 week, and 1 month. The controls behaved as expected. A two-way ANOVA revealed a significant difference (p = 0.01) between materials. Tukey's test isolated the difference to Super EBA as producing a superior seal but only at 24 h. There was no significant effect with time (p = 0.57) or the interaction of the materials with time (p = 0.66). All materials sealed the perforations very well. The maximum leakage of all materials was <0.007 microL min(-1) cm H2O(-1).

Aluminum Compounds↗
PubMed2004

Resolution of furcation bone loss associated with vital pulp tissue after nonsurgical root canal treatment of three-rooted mandibular molars: a case report of identical twins.

This case report demonstrates the simultaneous development of furcation bone loss in three-rooted tooth #30 with vital pulp tissue in identical twins. In the first report, resolution of furcal bone loss was seen after nonsurgical root canal treatment. In the second report, furcal bone loss resolved after non-surgical root canal treatment, and periodontal therapy reduced probing depths to maintainable levels.

Adolescent↗
PubMed2001

Immediate implant in fresh extraction socket of resected mandibular first molar: a preliminary clinical report.

This study presents a new technique that involves resection of the affected mesial root in a lower mandibular molar with immediate implant placement in its extraction socket. This technique offers a treatment option for mandibular molars affected by local periapical infection, bifurcation involvement, or buccolingual fractures. Extraction of such molars usually creates a large edentulous span and subsequent restorative problems. The patient is provided with a crown that is supported by an implant in the resected mesial root site and the retained distal root. The crown is esthetic and functional and easy to maintain. This technique was successfully applied on five patients.

Adult↗
PubMed2005

Assessment of a novel alternative to conventional formocresol-zinc oxide eugenol pulpotomy for the treatment of pulpally involved human primary teeth: diode laser-mineral trioxide aggregate pulpotomy.

OBJECTIVE: The purpose of this study was to investigate whether a diode laser pulpotomy with mineral trioxide aggregate (MTA) sealing could be an acceptable alternative to the conventional formocresol pulpotomy and zinc oxide eugenol (ZOE) sealing in human primary teeth. METHODS: A randomized, single-blind, split-mouth study was used with a sample of 16 children aged from 3 to 8 years (mean age=5.10 years). A total of 26 pairs of teeth from these 16 patients were selected based on clinical and radiographic criteria. One tooth from each pair was randomly assigned to either the laser-MTA pulpotomy group or the formocresol-ZOE pulpotomy group. All teeth were followed up clinically and radiographically at 2.3, 5.2, 9.5 and 15.7 months. All extracted failures were sectioned and photographed to assess possible reasons for this. RESULTS: A total of seven laser-MTA-treated teeth were deemed to be radiographic failures (mean time until failure=9.1 months) compared to three formocresol-ZOE treated teeth (mean time until failure=12.5 months). These results were not significant using Fisher's exact test (P>0.05). Six of the laser-MTA failures and all three formocresol-ZOE failures exhibited furcal and/or periapical radiolucencies with or without pathologic root resorption. One of the laser-MTA failures displayed premature root resorption and is being observed for exfoliation. Analysis of photographs of teeth available for extraction revealed errors in clinical technique in addition to expected signs of a disease process such as the presence of granulation tissue and areas of pathologic root resorption. CONCLUSIONS: The laser-MTA pulpotomy showed reduced radiographic success rates compared to the formocresol-ZOE pulpotomy at 15.7 months; however, these results were not statistically significant. Improved success rates among a larger patient sample and a longer follow-up period would be required for the laser-MTA pulpotomy to be considered a routine alternative to the conventional formocresol-ZOE procedure. Meticulous restorative techniques must be followed to ensure the success of laser-MTA pulpotomies.

Aluminum Compounds↗
PubMed1994

The topography of the furcation entrance in Chinese molars. Furcation entrance dimensions.

The purpose of the present study was to document the furcation entrance dimensions (FEDs) of the maxillary and mandibular 1st and 2nd molars and relate them to the choice of periodontal therapy. Study samples consisted of 89 maxillary molars (49 1st and 40 2nd molars) and 93 mandibular molars (50 1st and 43 2nd molars). All the FEDs of the molars were examined and measured under a stereomicroscope at 2.5 x equipped with a Bioscan OPTIMAS Image Analyzer (BOIA). The results may be summarized as follows. (1) The mean FEDs in the buccal, distal and mesial furcations of maxillary 1st and 2nd molars were 0.74 mm, 0.99 mm and 1.04 mm in the 1st molars, and 0.63 mm, 0.67 mm, 0.90 mm in the 2nd molars, respectively. In the buccal and lingual furcations of mandibular 1st and 2nd molars, they measured 0.88 mm and 0.81 mm, and 0.73 mm and 0.71 mm, respectively. (2) The %s of FEDs of 0.56 mm or less (the tip width of a Cavitron tip being 0.56 mm) in the buccal, distal and mesial furcations of maxillary 1st and 2nd molars, accounted for 32%, 8% and 6% of 1st molars, and 40%, 40% and 18% of 2nd molars. In the buccal and lingual areas of mandibular 1st and 2nd molars, they accounted for 16% and 26%, and 35% and 33% of the furcations, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1994

The reliability of furcation measurements.

The furcation involvement of 100 molars in 25 patients suffering from moderate to advanced periodontitis was investigated. Presurgically, the horizontal probing attachment level (PAL-H) within the furcations was assessed 2 x within 14 days. To determine the measurement error of PAL-H, the standard deviation of single measurements was calculated. The measurements were repeated intrasurgically and compared with presurgical assessments of furcation degrees. The overall standard deviation of single measurements was 0.739 mm. For buccal, lingual, mesiolingual and distolingual furcations, the standard deviations were 0.602 mm, 0.559 mm, 0.759 mm, 1.099 mm, respectively; measurement error was less in buccal and lingual furcations than in distolingual furcations (p < 0.001). The agreement of replicate measurements of furcation degrees was excellent for buccal, lingual and mesiolingual furcations (weighted k - coefficients between 0.776 and 0.944), but only moderate for distolingual furcations (kw = 0.706). Multiple linear regression analysis revealed significant influence of furcation depth, width and furcation location on differences of PAL-H (p < 0.05). There was no significant difference between furcation degree as assessed presurgically and intrasurgically.

Adult↗