Clinical evaluation of tunneled molars: a retrospective study

The main concern associated with the tunneling procedure is the development of root caries on the furcation area post-treatment. The objective of this study was to evaluate the periodontal conditions and the prevalence of root caries in tunneled molars.

The study sample comprised 30 tunneled teeth (mean tunneling age = 3.6 years) in 18 subjects who had received periodontal treatment and were enrolled in a maintenance program that included the application of fluoride to the exposed root surfaces. Plaque index (PI), pocket depth (PD), bleeding on probing (BOP), decayed, missing, filled or sound teeth (DMFT) and demographic characteristics were assessed. Statistical analysis was performed using the Friedman and Mann-Whitney tests and multiple linear regression analyses.

Four teeth (13.4%) showed active root caries inside the tunnels. Six (5.4%) of the 109 root surfaces facing the furcation region (inner surfaces) were affected by carious lesions, similar to the amount of root caries observed on the outer tunnel root surfaces, where 10 (5.3%) of the 189 surfaces studied were restored (p > 0.05). The interior of the tunnels had a higher percentage of sites with PD > or =6 mm then the exterior (p > 0.05). However, the plaque indexes and BOP scores were low for both the internal and external surfaces of the tunnels. Regression analysis indicated that the only positive association with the development of caries inside the tunnels was previous root caries experience (beta = -0.671; p = 0.01).

The results show that tunneling is a suitable technique to treat periodontal furcation lesions in individuals following a regular maintenance program.