Periodontal Photo Essay
Q: Why do we barrel in furcations?
A: By removing the overhanging lip on the furcation, we usually find bone to be more coronal in the furcation, creating a parabolic architecture and maintainable environment. No further breakdown should occur.
Q: Why do we barrel in a furcation to the occlusal surface when fabricating a new crown?
A: When we contour the crown so the barreling in goes to the occlusal surface, the patient can clean everywhere; there is no plaque buildup. If we can stop short of the occlusal surface, we find plaque accumulates and it is as though the furcation is still present.
Q: How do you contour a new restoration once the tooth has been biologically shaped?
A: The new restoration follows the contours of the shaped tooth and does not have a height contour placed on the buccal.
Q: Should the contours of the new restoration follow the shaped tooth?
A: Yes, to allow for the proper maintenance by the patient and hygienist. As previously discussed, any furcation that is barreled in should be carried to the occlusal surface.
Q: Does vertical probing in the furcation area tell what periodontal issues may exist?
A: No, as the furcation may approximate the old margin, causing the possibility of future problems for the furcation and new crown. It is important to eliminate any furcation present prior to placement of a new restoration.
Dr. Daniel Melker is in private practice and can be reached at 727-725-0100.