| Summary: | 碩士 === 高雄醫學大學 === 牙醫學研究所 === 91 === Because of the inconsistent results of periodontal and prosthetic therapy, periodontists usually could not choose adequate instruments to treat molars furcation involvements (FI) with poor root morphology. In addition, poor root morphology of the remaining root following surgical or non-surgical treatment is usually considered a high risk factor for long-term periodontal personal and professional plaque control. The purpose of this study was to investigate the differences in the clinical periodontal parameters of molar abutment with or without molar roots separation and/or resection (RSR) before and after periodontal and prosthetic therapy in severely advanced periodontitis (SAP) combined with trauma from occlusion (TFO), using a removable therapeutic provisional prosthesis (TPP).
Samples were pooled from patients with advanced Class II or Class III molar furcation involvement treated at the Department of Periodontics, Kaohsiung Medical University Memorial Hospital, Taiwan. A total of 50 abutments consisted of 37 maxillary and 13 mandibular molars, were treated in 31 individuals. There were 17 abutment without root separation/resection and 33 abutments with RSR. Twenty-five TPPs were placed, 18 in the maxillary arch and 7 in the mandibular arch. The mean observation period was 14.8 ± 2.0 months (ranged from, 12 to 18 months). The clinical parameters including plaque index (PlI), gingival index (GI), probing pocket depth (PPD), probing attachment level (PAL), and tooth mobility (M) were recorded. The differences in these parameters before and after periodontal and prosthetic therapy in the advanced furcation-involved molars with and without RSR were evaluated. The results revealed a remarked significant improvement in the associated periodontal parameters (PlI: p <0.001, GI: p <0.001, PAL-NFI: p <0.01, PAL-FI: p <0.001, PD-FI: p <0.001, M: p <0.001) in advanced Class II and Class III FI molars with RSR combined with TPP as compared to those without RSR. It was, therefore, concluded that molar abutments with RSR in conjunction with a specifically designed TPP provide a modified approach for treating molars with advanced Class II and III FI.
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