[Treatment of furcation involvement--implantation of alloplastic materials]

Based on the results of clinical and experimental research, the treatment of furcation-involved teeth by alloplastic implant is critically evaluated. Only materials like calcium phosphate ceramic have shown to be of therapeutic value. Clinically it was found in reentry surgeries 6 months after implantation that the vertical and horizontal components of grade II furcation-involved mandibular molars were reduced to a greater extent with hydroxyapatite implants compared to flap surgery alone. Histological studies in animals were performed only in periodontal infrabony defects; these data yielded contradictory results. However, most studies showed that the apical migration of the epithelium along the root surface was reduced and periodontal regeneration was enhanced. Because these results cannot be extrapolated to the specific situation in the furcation area, the routine treatment of furcation-involved teeth with alloplastic implants is not recommended. Possible future aspects of this treatment modality may involve a combination of the membrane technique with alloplastic implants as well as a temporary closure of the involved furcation entrance with a sterile bone cement. These techniques are based on the principle of guided tissue regeneration. Both treatment modalities demonstrate promising results.