Lack of furcal bone loss following the tunneling procedure

Treatment of molar teeth with severe furcation involvement allows for differing therapies of which the tunneling procedure has been least studied. While subsequent root caries in furcal exposed teeth was believed a major shortcoming, successful periodontal therapy is primarily dependent upon the stability of the attachment and intrafurcal and interproximal bone. We evaluated in each of 18 subjects (10 female, 8 male) a molar tooth with deep grade II/III furcation involvement at time of presentation (T-0), to 1st post-surgical recall following a tunneling procedure (T-1), to most immediate last recall (T-2; mean time T-0 to T-2, 5.80 +/- 0.83 years). Assessments included O'Leary's plaque index (P1-I), attachment levels (AL), root caries and radiographic bone loss. The mean P1-I from T-0 to T-2 decreased 56.8% with some plaque at T-2 detected in furcations of 7/18 teeth. AL across all time periods were not significantly difference except for palatal/lingual AL which from T-0 to T-2 were significantly different. Root caries was found in only 3 teeth at T-2. Adequate radiographs were available for 8 surgically tunneled mandibular molars for analysis of 5 measurements of osseous levels i.e., the mesial and distal levels of the intrafurcal and the interproximal osseous crests, and the distal interproximal osseous crest of a mesial adjacent single-rooted reference tooth which received osseous surgery at the same time. Mean time change values (T-1 to last radiograph taken, T-2a; mean time 3.0 +/- 0.7 years) showed no significant difference among the 5 points measured.(ABSTRACT TRUNCATED AT 250 WORDS)