SURGICAL TREATMENT OF CLASS II FURCATION DEFECTS: ARE THERE NEW REGENERATIVE TECHNIQUES?

Aim: complex anatomical features and limited accessibility to the furcation area make the periodontal management of multi- rooted teeth challenging. The aim of this study is to investiga- te a new surgical approach in periodontal regeneration of class II furcation defects. Methods: 20 subjects diagnosed with a stage III grade B pe- riodontitis with class II furcation defects, homogenous for de- fect and furcation anatomical characteristics, were selected. The test group (n = 10) underwent a new surgical approach, consisting in Piezosurgical Roof Furcation Contouring (PRFC), grafting and Coronally Advanced Flap (CAF). The control group (n = 10) was treated with Open Flap Debridement (OFD). Clinical and radiologic variables, such as bleeding on probing (BoP), probing depth (PPD), vertical and horizontal bone level, gingival recession, root trunk length, radicular separation, and furcation perimeter, were evaluated at baseline, 180 days and 1 year after surgery (FU). Results: in the test group a CAL gain (6.00 ± 1.15 vs 3.00 ± 0.66 mm), horizontal probing attachment level gain (6.00 ± 1.56 vs 3.10 ± 0.73 mm) and PPD reduction (4.20 ± 0.92 vs 2.70 ± 0.48 mm) were observed, comparing baseline to FU da- ta. Test group showed greater radiographic reduction of furca- tion perimeter (5.42 ± 1.38 vs 2.67 ± 0.98 mm). Conclusions: this new surgical technique has shown greater clinical improvement at FU compared to the baseline. Regene- rative surgery carried out with PRFC and CAF led to better cli- nical outcome compared to the control group, with better clo- sure and healing of the class II furcation defects.