Mandibular and maxillary furcation tunnel preparations--literature review and a case report

The objective of this literature review and subsequent case report is to discuss and illustrate the tunnel preparation procedure as a treatment alternative for furcation-involved molars.

Furcation tunnel preparation, i.e., the creation of access for plaque control between periodontally diseased roots, has not been discussed in the literature as comprehensively as root resective therapy, though success rates appear to fall within the same range. A short root trunk and a wide furcation entrance diameter are prerequisites for the indication of the tunnel preparation procedure. Although accessory canals in the furcation area are frequent findings on extracted teeth, endodontic complications have not been reported to be major complications after tunnel preparation. Caries developed at tunneled teeth even under proper maintenance, but did not necessarily lead to the loss of an affected tooth.

In the case presented to illustrate the indication for the tunnel preparation procedure, periodontal disease was almost entirely restricted to the furcation sites of molar teeth. Affected teeth were either extracted or left intact and subjected to tunneling procedures. Periodontal health could be established and maintained at both single and double tunnels over a period of 2 years of periodontal supportive therapy.