Due to the complicated anatomical structures in the furcation area of multirooted mandibular first molars, dental hygiene is greatly compromised once the furcation is involved in the periodontitis, leading to the unfavorable prognosis of teeth with furcation involvement. A patient came to a dental office with the chief complaint of "mobile mandibular posterior tooth" 27 years ago. The periapical film showed alveolar bone resorption at the root furcation of the right mandibular first molar. Flap surgery and fine supportive therapy were conducted. The patient was diagnosed with "furcation involvement Class Ⅲ" during a revisit three years ago. Satisfactory and healthy periodontal statuses were observed 2, 9, 24, and 33 months after the periodontal flap surgery plus tunneling procedures. A follow-up of 27 years in the present case demonstrated that a favorable prognosis of furcation involvement can be achieved after adequate periodontal treatment.
Follow-Up Studies ; Furcation Defects/surgery* ; Humans ; Mandible ; Molar ; Periodontitis

BACKGROUNDGuided tissue regeneration procedures provide predictable reconstruction of periodontal tissues in the treatment of furcation involvements in animals and humans. This study was to compare long-term effectiveness of two different types of polylactic acid (PLA) membranes on periodontal regeneration in surgically created class II furcation defects in dogs.

METHODSFull thickness mucoperiosteal flap was raised on the buccal aspects of the experimental teeth and class II furcation defects having 5 mm vertical dimensions were created on mandibular premolar III and IV on each quadrant. The exposed root surfaces were thoroughly planed and PLA membranes were placed over the experimental defects on both sites. One site received liquid polymer membrane (LPM), and resorbable periodontal mesh (RPM) membranes were applied to the other site. The animals were sacrificed at 7 months after surgery and the specimens were processed for histological evaluation.

RESULTSThe average length of new attachment formed on the treated roots in both groups ranged from 3.02 mm to 4.5 mm. Complete bone filling was observed at the furcation sites. No statistically significant differences were found between two membranes in any of the parameters (P > 0.05).

CONCLUSIONThis study demonstrates favorable regenerative outcomes by the use of two different types of PLA membranes that could be used as alternatives for guided tissue regeneration (GTR).

Animals ; Dogs ; Furcation Defects ; surgery ; Guided Tissue Regeneration, Periodontal ; methods ; Lactic Acid ; analogs & derivatives ; therapeutic use ; Periodontium ; physiology ; Polymers ; therapeutic use ; Wound Healing ; physiology