Regenerative Treatment of Class II Mandibular Furcation Defects

Procedure

• Case description: Class II furcation defect at teeth 46 and 47 and gingival recessions at teeth 43 and 44
• Root planing using PerioSet
• Incision technique
• Cleaning furcation defect at tooth 46
• Pref Gel application, rinsing and Emdogain application
• Insertion of Bio-Oss into the furcation space with an amalgam plugger after hydration
• Condensation of the bone replacement material and application of an absorbable membrane (Bio-Gide)
• Atraumatic suture closure using 6/0 Seralene

Contents
This video demonstration shows the simultaneous treatment of recessions at teeth 43 and 44 and of class II furcation defects at teeth 46 and 47. After a brief case description, root planning is done using PerioSet. Next, an incision is made and the furcation defects are very carefully cleaned using hand instruments and ultrasonic scalers (Soniflex). The cleaned root surfaces and furcation defects are conditioned with Pref Gel (Straumann) for two minutes. The objective of conditioning is to remove the smear layer, to open the dentine tubules, and to enable surface demineralization. Moreover, this measure serves to optimize the contact between Emdogain and the root surface. After two minutes, the EDTA suspension is removed using physiological saline solution or water spray. Immediately afterwards, Emdogain is applied to the blood and saliva-free root surface. This procedure was also used to treat the furcation defect at tooth 47. Regenerative treatment of tooth 46 was performed since that tooth had a very extensive furcation defect. The defect was filled with Bio-Oss, which was applied using an amalgam plugger. Absorbable Bio-Gide was used for coverage of the furcation entrance. Finally, the wound was closed using loop sutures and single interrupted sutures.