Main Article Content
Aim: The preservation of a functional dentition is very important in young individuals. Mandibular molar teeth, the first to erupt in the oral cavity are highly susceptible to caries. Pulpal involvement of these teeth along with furcation defects is a challenge to the maintain them in a functional occlusion. Advances in Restorative and Periodontal dentistry have made this possible.
Presentation of Case: This is a case report of a 20 year old male patient with a chief complaint of pain and mobility in the mandibular left first molar. On examination, the tooth had a carious involvement, was sensitive to percussion and revealed grade 1 mobility with Glickman’s grade III furcation defect. A provisional diagnosis of a primary endo with secondary perio with tooth number 36 was given. On radiographic examination, bone loss was evident involving the furcation area. Root canal treatment was performed along with hemisection of tooth.
Discussion: In the Past cases exhibiting Glickman’s grade II or III furcation defects were considered untreatable. Root resection procedures help maintain a part or the entire tooth. These procedures are highly complex and their success depends upon a proper case selection.
Conclusion: The conservative management of teeth in young patients showing furcal defects can not only help maintain the tooth in functional dentition but it also reduces the financial burden, psychological stress and occlusal dysfunction.
Andreasen FM, Andreasen JO, Cvek M. Root fractures. In: Textbook and Color Atlas of Traumatic Injuries to Teeth. Andreasen FM, Andreasen JO, eds. Copenhagen: Blackwell Publishing Ltd. 2007;337– 371.
Flores MT, Andersson L, Andreasen JO, Bakland LK, Malmgren B, Barnett F, et al. Guidelines for fractured and luxated permanent teeth. Dent Traumatol. 2007; 23:66–71.
Sharma S, Sharma R, Ahad A, Gupta ND, Mishra SK. Hemisection as a conservative management of grossly carious permanent mandibular first molar. J Nat Sc Biol Med. 2018;9:97-9.
Schetritt A, Steffensen B. Diagnosis and management of vertical root fractures. J Can Dent Assoc. 1995;61:607–613.
Parmar G, Vashi P. Hemisection: A case-report andreview. Endodontology. 2003; 15:26-29.
Saxe SR, Carman DK. Removal or retention of molar teeth: The problem of the furcation. Dent Clin North Am. 1969; 13:783-790.
Gantes BG, Synowski BN, Garrett S, Egelberg JH. Treatment of periodontal furcation defects: Mandibular Class III defects. J Periodontol 1991;62:361-365.
Lindhe JK. Clinical periodontology and implant dentistry. 4th ed. Oxford: Blackwell Publishing Ltd. 2003;705-730.
Ross IF, Thompson RH. A long-term study of root retention in the treatment of maxillary molars with furcation involvement. J Periodontol. 1978;49: 238-244.
Farrar JN. Radical and heroic treatment of alveolar abscess by amputation of roots of teeth. Dental Cosmos. 1884;26:79.
Arhun N, Arman A, Ungor M, Erkut S. A conservative multidisciplinary approach for improved aesthetic results with traumatized anterior teeth. Br Dent J. 2006;201:501–512.
Luebke RC. Vertical crown-root fractures in posterior teeth. Dent Clin North Am. 1984; 28:883–895.
Farshchian F, Kaiser DA. Restoration of the split molar: bicuspidization. Am J Dent. 1988;1:21-22.
Needleman I. How long do multirooted teeth with furcation involvement survive with treatment? Evid Based Dent. 2010; 11(2):38-9.
Setzer FC, Shou H, Kulwattanaporn P, Kohli MR, Karabucak B. Outcome of crown and root resection: A systematic review and meta-analysis of the literature. J Endod. 2019;45(1):6-19.