The furcation problem. Current controversies and future directions

Effective management of furcation regions affected by periodontal destruction includes accurate assessment of etiologic factors, careful diagnosis of furcation involvement, and an appropriate plan of therapy. Many forms of therapy have been advocated; most have been designed to allow adequate professional and personal removal of plaque from the furcation. All types of traditional therapy have disadvantages that must be carefully considered by the therapist and the patient. Newer treatment modalities attempt to regenerate periodontal attachment in the furcation. The techniques do not have sufficient controlled documentation at this time to warrant unqualified support, but they appear to be biologically feasible and hold considerable clinical promise. At this time, guidelines for management of a periodontally involved furcation region must stress application of the simplest therapy that is likely to provide clinical stability. Longitudinal data from carefully controlled clinical trials comparing therapy techniques are needed to refine our clinical judgment.