Three-dimensional imaging as a pre-operative tool in decision making for furcation surgery

Area of Science:

• Dentistry
• Radiology
• Periodontology

Background:

• Furcation involvement (FI) in maxillary molars presents diagnostic challenges.
• Clinical examinations and periapical radiographs may not fully capture the extent of FI.
• Accurate assessment is crucial for effective periodontal treatment planning.

Purpose of the Study:

• To evaluate the utility of cone beam computed tomography (CBCT) for assessing furcation involvement (FI) in maxillary molars.
• To compare CBCT findings with clinical assessments and periapical radiographs.
• To determine the impact of CBCT on treatment decisions for maxillary molar FI.

Main Methods:

• CBCT scans were performed on 22 maxillary molars in 12 patients with chronic periodontitis and clinical FI.
• CBCT images were analyzed to assess FI, bone-supported root length, and anatomical features.
• FI and treatment recommendations from CBCT were compared to those from clinical exams and periapical radiographs.

Main Results:

• CBCT confirmed clinical FI in 27% of sites, but revealed underestimation in 44% and overestimation in 29%.
• Underestimation of FI by clinical methods was significant, especially for degrees II and II-III.
• Discrepancies between clinical and CBCT-based treatment plans ranged from 59% to 82%.

Conclusions:

• CBCT provides comprehensive information on furcation involvement in maxillary molars.
• CBCT serves as a reliable basis for making informed treatment decisions.
• Utilizing CBCT can lead to more accurate and appropriate management of periodontal disease in maxillary molars.