Resective periodontal surgery in the treatment of furcation lesions

The purpose of this paper is to review and discuss the resective therapy in the treatment of furcation involvements. The treatment of furcation lesions can be classified into conservative (surgical and nonsurgical), resective and regenerative approaches. Although regeneration of the periodontium is the ideal situation, not all furcations can be treated effectively with regenerativetechniques. In addition, furcation lesions are particularly difficult to treat using either surgical or nonsurgical conservative approaches. Resective therapies, such as hemisection, rootamputation and tunneling, have been used to treat furcation defects for over a hundred years. Irrespective of the treatment modality employed, the anatomy of the furcation area makes it very difficult to be maintained free of bacterial plaque and thus of inflammation. Resective therapy aiming to eliminate all plaque retaining factors has been used in periodontal defects with advanced horizontal bone loss and in Class II and III furcation involvements. The literatureagrees that resective therapies have a high degree of complexity requiring advanced surgical and reconstructive skills to be performed correctly. However, despite its complexity, resectivetherapy is an essential part of the periodontal therapy used to treat specific problems involving furcation defects that cannot be solved by other surgical or nonsurgical approaches.