[Root resection in the era of dental implants]

The treatment of furcation defects is one of the most challenging aspects of periodontal therapy. The periodontal therapist can utilize various treatment modalities, including: non surgical root debridement, local drug delivery, open flap surgery, tunneling, root resection, guided tissue regeneration and extraction. Each treatment method has its advantages and disadvantages. The dilemmas concerning tooth prognosis and prosthetic considerations in such cases are especially demanding, especially in comparison to implant therapy. The clinician's decision in these situations must comply with the objective condition in the particular case based on his abilities and knowledge and the patient expectations. In order to evaluate the relevancy of root resection procedures we reviewed the literature focusing on root resection therapy prognosis as well as the different therapeutic alternatives for furcated molar teeth. Root resection treatment guidelines, indications and contraindication are presented along with clinical examples. Root resection is currently a relevant treatment modality for furcation defects. By using proper case selection, good surgical technique, proper prosthetic treatment and good periodontal supportive care, a good 5 year prognosis can be achieved and complications can be minimized. In light of the growing literature concerning dental implants complications, extraction and dental implant placement should be recommended as the last option when all other conservative options cannot be used, or following their failure.