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Three-dimensional imaging as a pre-operative tool in decision making for furcation surgery.

AIM
To investigate the use of cone beam computed tomography (CBCT) in assessing furcation involvement (FI) and concomitant treatment decisions in maxillary molars.


MATERIAL AND METHODS
Twelve patients with generalized chronic periodontitis were consecutively recruited and CBCT was performed in maxillary molars (n=22) with clinical FI and increased probing pocket depths. CBCT images were analysed and FI, root length supported by bone and anatomical features were evaluated. FI and treatment recommendations based on clinical examinations and periapical radiographs were compared with data derived from CBCT images.


RESULTS
The estimated degree of FI based on clinical findings was confirmed in 27% of the sites, while 29% were overestimated and 44% revealed an underestimation according to CBCT analyses. Among degree I FI, 25% were underestimated, among degree II and II-III, the underestimation was as high as 75%, while all sites with degree III FI were confirmed in the CBCT. Discrepancies between clinically and CBCT-based therapeutic treatment approaches were found in 59-82% of the teeth, depending on whether the less invasive or the most invasive treatment recommendation was selected for comparison.


CONCLUSIONS
CBCT images of maxillary molars may provide detailed information of FI and a reliable basis for treatment decision.