SUCCESSFUL REGENERATION OF MANDIBULAR CLASS-II FURCATION DEFECTS - ANEVIDENCE-BASED TREATMENT APPROACH

The purpose of the present evidence-based critical review was to defin e goals and outcomes for regenerative therapy of Class II furcation de fect's and rank the efficacy of current regenerative procedures based on the available literature. Metaanalysis was employed to quantitate t he mean overall expected changes and compare various techniques. The e vidence presented in the literature was used to determine factors affe cting regeneration of Class II furcation defects. These factors were u sed to establish decision-making frees to enhance success and highligh t potential shortcomings of the technique. Guided tissue regeneration used alone or in combination with bone replacement grafts, had the hig hest overall ranking. Mean reduction in probing depths and gains in ve rtical and horizontal attachment levels were all statistically signifi cant at 6 months. Similar results were obtained in the 12-month studie s. Compared to nap debridement, guided tissue regeneration resulted in greater reduction in probing depths and greater gains in vertical and horizontal attachment levels. Guided tissue regeneration provided alm ost identical results whether used with or without root conditioning, suggesting that root conditioning does not offer an adjunctive effect. A combination of guided tissue regeneration and bone replacement graf ts yielded better results than did guided tissue regeneration alone in reducing probing depths and increasing vertical attachment levels. Th e decision-making trees derived from analysis of these results may ass ist the clinician in improving success and predictability of guided ti ssue regeneration procedures in Class II furcation defects.