Orthodontic eruption of furca-involved molars

Guided tissue regeneration techniques, which are used in the treatment of certain advanced Class II and Class II furca-involved teeth, have progressed from promising to predictable. However, furca-modification techniques remain important aspects of treatment. Tooth eruption, combined with standard furca-modification techniques, improves the prognosis for both the treated and the adjacent teeth. Continued eruption of periodontally involved molars improves the crown-to-root ratio and maintains the periodontium of the adjacent dentition. These same concepts can be used to treat restoratively compromised molars, many of which were considered hopeless and subsequently extracted. Passive eruption can be useful in treating cases that need less than 3 mm of tooth eruption; orthodontic-active eruption with fixed appliances is advised if more than 3 mm of eruption is desired. Slower eruption rates (2 mm per month) allow the periodontal ligament to repair and the alveolar bone to remodel between orthodontic adjustments (3 to 4 weeks between adjustments). Periodic periodontal maintenance is accomplished during orthodontic treatment. After a retention period (8 weeks), periodontal++ surgery should be performed to reestablish the tooth's biologic width. After surgical wound healing (6 to 8 weeks), the tooth should be restored.