The mandibular molar class III furcation invasion: a review of treatment options and a case report of tunneling.
BACKGROUND
The predictable management of a mandibular molar that has lost all of its interradicular periodontal support-in other words, that has experienced a Class III furcation invasion, or FI-often is a frustrating and disappointing process for both clinician and patient. The strategic value of retaining such a periodontally involved tooth must be determined by both the patient and dentist before a treatment option is selected. In this article, the authors present and describe various therapeutic plans available for Class III FIs in mandibular molars, discussing the advantages and disadvantages of each approach. They focus particularly on a surgical technique called "tunneling," which is performed to débride the remaining soft and hard tissues in the furcal area; this, in turn, allows access for effective oral hygiene and maintenance.


METHODS
The authors report on the 23-year result of a case involving tunneling. The procedure facilitated the retention of a mandibular molar with a Class III FI in a manner acceptable to both the patient and the clinician.


CONCLUSIONS
Tunneling, in a properly selected patient who is motivated to perform careful oral hygiene, can result in comfortable, functional, healthy retention of the affected tooth, with a minimal commitment of time and financial outlay.
Vandersall
David C
DC
Department of Periodontics and Allied Dental Programs, School of Dentistry, Indiana University, Indianapolis 46202-5186, USA. dcvander@iupui.edu
Detamore
Robert J
RJ
D003646:Debridement; D012534:Dental Scaling; D005500:Follow-Up Studies; D017823:Furcation Defects / Q000145:classification / Q000601:surgery / Q000628:therapy*; D016557:Guided Tissue Regeneration, Periodontal; D006801:Humans; D008297:Male; D008334:Mandible; D008875:Middle Aged; D008963:Molar / Q000473:pathology*; D009910:Oral Hygiene; D010347:Patient Care Planning; D010510:Periodontal Diseases / Q000517:prevention & control; D016745:Root Planing; D013357:Subgingival Curettage; D014081:Tooth Extraction; D014092:Tooth Root / Q000601:surgery