Hypothetical considerations in the regenerative treatment of molar furcation defects

Treatment of the molar furcation defect is a challenge to the dental professional. Responses of molar furcation sites to both closed and open surgical debridement have not been shown to result in significant clinical improvement or bone fill. Regenerative techniques using grafting materials, guided tissue regeneration with resorbable and nonresorbable membranes, coronally positioned flaps, and combination techniques are more frequently used to treat class II molar furcations. The clinical responses to these surgical approaches have shown varied results. This article reviews some of the studies on regeneration in furcation defects as well as some of the uniqueness and complexities of the furcation problem. The bone morphology differences in molar bifurcation and trifurcation defects are discussed, and a bone morphologic classification is presented in an effort to standardize future regenerative studies in class II furcations.