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90 Periodontal-Restorative Interrelationships: Ensuring Clinical Success

Vertical furcation involvements are dened as


follows:
A. Subclass a: Loss of attachment apparatus
along less than 25% of the vertical compo-
nent of the furcation of the tooth.
B. Subclass b: Loss of attachment apparatus
along more than 25% but less than 50% of
the vertical component of the furcation of the
tooth.
C. Subclass c: Loss of attachment apparatus
along more than 50% of the vertical compo-
nent of the furcation of the tooth.
Although the vertical component of a furca-
tion involvement has signicant ramications in
the treatment of Class II furcations, it plays a
minimal role in the treatment of Class I furcations,
unless the vertical involvement either extends to
such a degree as to render attainment of appropri-
ate osseous morphologies impossible, or reaches
the apices of the tooth in question. In such situa-
tions, regenerative therapy or molar extraction and
implant placement must be effected, depending
upon the extent of the problem.
Examination of the root morphologies facing
involved periodontal furcations demonstrates the
difculty, and often futility, of attempting to thor-
oughly debride these areas through the use of
curettes and/or ultrasonic instrumentation, either
through a closed or open - ap approach (Fig. 3.4 ).
Molars presenting with additional roots, whether
they be fully formed or vestigial in nature, pose an
even greater challenge to the treating clinician (Fig.
3.5 ).
horizontal and vertical dimensions. Horizontal fur-
cation involvements are dened as follows:
A. Class I: Entrance into the furcation proceeds
less than half of the horizontal dimension of
the tooth (Fig. 3.1 ).
B. Class II: Entrance into the furcation proceeds
greater that half of the horizontal dimension
of the tooth, but less than the full horizontal
dimension of the tooth (Fig. 3.2 ).
C. Class III: Entrance into the furcation pro-
ceeds along the complete horizontal dimen-
sion of the tooth, connecting both the buccal
and lingual furcation entrances (Fig. 3.3 ).
Fig. 3.1 Class I furcation involvements are noted on both
molars.
Fig. 3.2 Class II furcation involvements are present on
both the rst and second molars. The greater vertical com-
ponent of the furcation involvement on the rst molar
renders treatment of this area more problematic than the
Class II furcation on the second molar.
Fig. 3.3 Class III furcation involvements are noted on both
the rst and second molars.