Furcacion

J Clin Periodontol 2004; 31: 105–111 Printed in Denmark. All rights reserved

Copyright r Blackwell Munksgaard 2004

Radiographic parameters as prognostic indicators for healing of class II furcation defects
Horwitz J, Machtei EE, Reitmeir P, Holle R, Kim T-S, Eickholz P: Radiographic parameters as prognostic indicators for healing of class II furcation defects. J Clin Periodontol 2004; 31:105–111. r Blackwell Munksgaard, 2004. Abstract Objective: To evaluate radiographic measurements for use as prognostic indicators for healing of class II furcation defects following regenerative therapy. Material and Methods: In 17 patients (eight females), 33 class II furcation defects (mandibular buccal (n 5 10) and lingual (n 5 12), and maxillary buccal (n 5 11)) were treated using the barriermembrane technique. Twenty-six furcations were treated using a bioabsorbable membrane, while a nonresorbable membrane was used to treat the remaining seven furcation defects. Clinical parameters and standardized radiographs were obtained before as well as 6 and 24 months after therapy. All radiographs were digitized and evaluated by an examiner blinded to the clinical data. The following distanceswere measured: cemento-enamel junction line (CEJ-line) to alveolar crest (AC) at the furcation site (AC-CEJ line), CEJ-line to the furcation fornix (Fx-CEJ line), width of the furcation at the level of the AC (FW) as well as the distance from Fx to a straight line between the AC mesial and distal of the tooth (Fx-AC line). Results: Statistically significant (po0.001) horizontal attachment gainscould be observed 6 and 24 months after therapy (6 months: 1.49 Æ 0.85 mm; 24 months: 1.14 Æ 0.91 mm). However, a small but statistically significant (p 5 0.031) attachment loss of 0.35 mm was observed between the 6 and 24 months examination. Multilevel regression analyses identified baseline probing depth (p 5 0.0017) and 3 of the radiographic distances as prognostic factors: Fx-CEJ line (p 5 0.014),FW (p 5 0.0535), Fx-AC line (p 5 0.0827). Conclusion: The analysis of presurgical radiographs may yield information on the success of the regenerative therapy of buccal and lingual class II furcation defects. A long root trunk, a wide furcation entrance and an Fx coronal to the AC have negative influences on the success of therapy. Further, a deep probing depth at the furcation site at baselineincreases the likelihood for more favourable horizontal attachment gain in furcations.

Jacob Horwitz1, Eli E. Machtei1, Peter Reitmeir2, Rolf Holle2, Ti-Sun Kim3 and Peter Eickholz3
Periodontal Unit, Department of Maxillofacial Surgery, Rambam Medical Center, Haifa 31096, Israel; 2GSF-National Research Center for Environment and Health, Institute of Health Economics, 85758 Neuherberg, Germanyand 3Section of Periodontology, Department of Operative Dentistry and Periodontology, Dental School, Ruprecht-Karls-University Heidelberg, 69120 Heidelberg, Germany
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Key words: class II furcation defects/therapy; guided tissue regeneration; membranes, artificial; membranes, barrier; polytetrafluoroethylene/therapeutic use; radiography, dental; radiography, dental, linear measurements Accepted forpublication 10 April 2003

Periodontal therapy using guided tissue regeneration (GTR) in class II furcation defects demonstrated more favourable clinical results than debridement surgery alone (Pontoriero et al. 1988, Caton et al. 1994, Pontoriero & Lindhe 1995a, Avera et al. 1998). Different factors influence the outcome of GTR therapy in furcation defects (Eickholz & Hausmann 1997, 1999, Sanz& Giovan-

noli 2000). Patient-related general factors, including inconsistent plaque control levels, smoking and infrequent supportive treatment (Eickholz et al. 2000, 2001), lead to less favourable results. Additionally, local factors related to defect characteristics seem to influence therapeutic outcome (Eickholz et al. 2001). These include the degree and location of the furcation. Whereas...