Clinical concepts for regenerative therapy in furcations

Area of Science:

• Periodontal regenerative medicine
• Periodontal therapy outcomes
• Dental tissue engineering

Background:

• Furcation involvements are complex periodontal defects, notoriously difficult to treat with conventional methods.
• Existing regenerative procedures aim to eliminate or reduce furcation depth, but predictability remains a challenge.
• Mandibular and maxillary molars with furcation involvement show poorer prognoses than non-involved teeth.

Purpose of the Study:

• To review the effectiveness of current regenerative therapies for periodontal furcation defects.
• To identify limitations and explore potential advancements in furcation regeneration.

Main Methods:

• Review of existing studies and systematic reviews on membrane therapy (guided tissue regeneration) and enamel matrix proteins.
• Analysis of data regarding bone grafts/substitutes in conjunction with guided tissue regeneration.
• Evaluation of preclinical and early-stage clinical data for growth factors, differentiation factors, and cell-based therapies.

Main Results:

• Guided tissue regeneration is effective for Class II buccal furcations but does not guarantee complete closure.
• Enamel matrix proteins show clinical improvement for buccal Class II defects, with limited complete closure rates.
• Neither guided tissue regeneration nor enamel matrix proteins are predictable for approximal Class II or Class III furcations.

Conclusions:

• Current regenerative treatments for furcation defects have established indications and limitations.
• Complete resolution of furcation defects is not consistently achieved with existing modalities.
• Novel regenerative strategies are essential to enhance the predictability and success of furcation defect treatment.