Periodontal considerations for functional utilization of a retained root after furcation management

The rationale for periodontal treatment in this case was that inflammatory perio‐dontal disease can be arrested by creating a dento‐gingival anatomy which is accessible for daily plaque removal techniques and that hypermobility per se does not mandate splinting to adjacent, less mobile teeth. These principles were applied to the management of a maxillary molar with advanced furcation involvement. In order to resolve the furcation problem it was necessary to amputate the palatal and disto‐buccal root which resulted in retention of the mesio‐buccal root. Although this retained root was hypermobile, this was not reason in itself to justify splinting. Splinting would be necessary only if the mobility interfered with masticatory function or increased progressively. Since this would not be known until the behavior of the tooth was observed in function, the root was restored as an independent unit. The occlusion was designed so that the crown had no premature contacts in the retruded or intercuspal positions and no non‐working side contacts in lateral excursion. The margins of the crown were kept supragingival. In the weeks following crown placement, no increase in mobility occurred although the tooth was in full masticatory Function. One year later there had been no change in the mobility status. It was concluded that the retained mesio‐buccal root which had reduced periodontal support and a degree of hyper‐mobility was capable of independent function. No periodontal breakdown occurred due to this mobility. Furthermore, efficient removal of plaque prevented recurrence of inflammatory periodontal disease and, in the presence of this plaque control, root caries did not develop after placing the crown margins in a supragingival location.