24.07.2015
The use of optional GC Fuji PLUS Conditioner prepares the bonding surface, which dramatically increases the bond strength and reduces the chance of pulpal sensitivity.
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Furcation invasion implies the attachment loss in the bifurcation or trifurcation of the multirooted teeth through the progress of inflammatory periodontal disease. This item will be shipped through the Global Shipping Program and includes international tracking. Will usually ship within 1 business day of receiving cleared payment - opens in a new window or tab. By submitting your bid, you are committing to buy this item from the seller if you are the winning bidder. By clicking Confirm, you commit to buy this item from the seller if you are the winning bidder. By clicking Confirm, you are committing to buy this item from the seller if you are the winning bidder and have read and agree to the Global Shipping Program terms and conditions - opens in a new window or tab. A 20 second application of GC Fuji PLUS Conditioner removes smear layer with a mild citric acid etchant and seals dentinal tubules with its ferric chloride component.
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The role of the prosthodontist in restoring root-resected molars: A study of 70 molar root resections. Guided tissue regeneration in the treatment of furcation defects in mandibular molars: A clinical study of degree III involvements.
Guided tissue regeneration in the treatment of degree III furcation defects in maxillary molar. Contact the seller- opens in a new window or tab and request a shipping method to your location. You have read and agree to the Global Shipping Program terms and conditions - opens in a new window or tab.
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Radiographic changes may or may not be visible due to overlapping of the roots.Class III is through and through invasion of the furcation area with soft tissue covering. Class IV is also through and through invasion, clinically visible due to soft tissue recession along with bone loss. The management and long-term retention of molars exhibiting furcation invasion have always been a challenge in dentistry.
The focus of treatment is to debride the remaining soft and hard tissues in the furcal area and allow access for effective oral hygiene and maintenance. Continued periodontal breakdown may lead to eventual loss of the teeth involved unless these defects can be repaired or eliminated and health of the tissues restored. Review of literatureThe nonsurgical or conservative treatment of mandibular molars with Class III furcation invasions (FI) has had a long history. Hirshfeld and Wasserman [2] found that repeated subgingival scaling, rootplaning and gingival curettage may be important in the long-term retention of molars with Class III FIs.
Bower [3] stated that furcal openings of mandibular molars frequently are narrower than the blade of frequently used curettes. Owing to morphological complications present in mandibular furcation, curettes used alone may not be adequate for root preparation, and narrow diameter ultrasonic debridement tips may be more of an appropriate choice. Another approach to treating a Class III FI of a lower molar is "bisectioning." The clinician splits the mandibular molar vertically through the furcation, without removing either half, leaving two separate roots that are then treated as bicuspids (a procedure termed "bicuspidization").


According to Newell [9] the advantage of the amputation, hemisection or bisection is the retention of some or all of the tooth.
However, the disadvantage is that the remaining root or roots must undergo endodontic therapy and the crown must undergo restorative management.The principle of Guided guided Tissue tissue Regeneration regeneration (GTR) was given by Nyman et al. GTR, as defined by the American Academy of Periodontology in its glossary of periodontal terms, is the "regeneration of periodontal attachment through differential tissue responses." Barrier techniques, using materials such as expanded polytetrafluoroethylene, polyglactin, polylactic acid, calcium sulfate, and collagen are employed in the hope of excluding epithelium and the gingival corium from the root in the belief that they interfere with regeneration. Tarnow and Fletcher [12] described a subclassification system of furcation classification based on the vertical measurement of bone loss, from the roof or fornix of the furcation to the level of interradicular bone. Thus, any Class III mandibular furcation with a vertical subclassification of B or C would not be indicated for a GTR procedure.Tunneling is a periodontal surgical procedure that creates access for patient cleaning and maintenance within the furcal area of a molar tooth that has incurred severe attachment loss owing to periodontal disease. Regenerative techniques that have been successful in the treatment of class II mandibular furcation invasions have been less than predictable when performed in class III FIs. The authors reported the greatest biocompatibility with glass ionomer via radiographic and histological evaluation.
Scherer and Drago [20] utilized modified resin ionomer restorations subgingivally and gave histological evidence of epithelial and connective tissue adherence to the resin ionomer restorative materialsIn the present case, a glass ionomer restorative material was used as an occlusive barrier in the treatment of mandibular first molar Class III furcation invasion.
Thorough scaling and root planing was done, and the patient was assessed for maintenance of oral hygiene.
Overall health of the dentition improved after Phase I therapy, but the involved tooth presented with persistent inflammation. GIC was placed in the furcation area and adapted using plastic instruments and Mylar strip.
A 2 mm space was left between the alveolar crest in the furcation area and the apical end of the restoration to allow for some amount of osseous regeneration [Figure 5].
The patient was advised to use 0.2% chlorhexidine gluconate mouth rinse twice daily for two weeks and was provided with postoperative and home care instructions. The patient was prescribed antibiotics (amoxicillin 500 mg, three times daily for seven days) to reduce the risk of infection postoperatively. Patient returned weekly for the first month for postsurgical evaluation and reinforcement of plaque control.
The patient was seen at three month and six-month interval for supportive periodontal care. Not only does the barrier seal the furcation entrance from epithelial, bacterial, and food debris invasion, but may also enable easier home care due to the reduced surface area of the furcation left to clean. Various studies [20],[21],[22] have shown radiographic and histological evidence of GIC biocompatibility.



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