Vital Root-resective Therapy in Furcation-involved Maxillary Molars

Launched by UNIVERSITY OF SANTIAGO DE COMPOSTELA · Feb 17, 2022

Keywords

ClinConnect Summary

This clinical trial is looking at a treatment called vital root-resective therapy for patients with severe gum disease, specifically focusing on maxillary molars (the upper back teeth) that have significant bone loss. The main goal is to see how well this treatment works over the course of one year for these specific teeth, which have a certain type of furcation involvement—this means there is bone loss around the roots of the tooth making it harder to clean and maintain.

To be eligible for this study, participants should have at least 12 teeth, a diagnosis of severe gum disease, and at least one affected maxillary molar that meets specific criteria, such as having a certain level of bone loss and gum pocket depth. Participants should also have recently completed non-surgical gum treatment and should be able to respond positively to sensitivity tests. This trial is currently active, and while they are not recruiting new participants at the moment, it’s important for potential candidates to know that individuals with certain health issues or specific dental conditions may not qualify. If selected, participants can expect to undergo a surgical procedure aimed at improving their dental health, with follow-up evaluations over the next year.

Gender

ALL

Eligibility criteria

• • Inclusion Criteria
• • Minimum of 12 teeth present
• • Diagnosis of Severe Periodontitis stage III or IV (Tonetti et al., 2018)
• • At least one maxillary molar with: i) degree II-III horizontal furcation involvement (Eickholz and Walter, 2018), ii) class C vertical furcation involvement (bone loss up to the apical third of root cones) (Tarnow and Fletcher, 1984, Tonetti et al., 2017), iii) residual probing pocket depths \> 5 mm, iv) maximum mobility degree I (Hamp et al., 1975) and v) not already accessible for self-performed oral hygiene
• • Received a course of non-surgical periodontal therapy within the past six months
• • Positive response to electric and cold testing
• • Exclusion Criteria
• Patient:
• • Full mouth plaque score \> 30%
• • A course of antibiotics within the past 3 months
• • Pregnant/lactating women
• • Relevant medical history as evaluated by the examining clinician which may have the potential to affect periodontal surgical treatment (such as disease affecting clotting ability)
• • Individuals on long-standing (2 or above years) supportive periodontal therapy (SPT) management plans
• Molar affected by FI:
• • Ongoing endodontic pathology affecting the furcation-involved molar, as judged by the examining clinician
• • Teeth associated with signs or symptoms indicative of pulpal or periapical pathology
• • Evidence of coronal cracks upon root resection
• • Previous periodontal surgical treatment to the furcation-affected molar within the previous 5 years
• • Endodontically treated tooth
• • Restorations affecting more than 2 walls or 1 cusp
• • Molar tooth acting as a bridge abutment
• • Planned for extraction (for strategic/restorative reasons)
• • Root trunk exceeding ½ of the total root length
• • Fused roots
• • Remaining furcation not accessible for self-performed oral hygiene
• • The presence of occlusal dysfunction as assessed by the examining clinician
• • Sinus floor anatomy limiting possible osseous resective surgery
• • Tooth mobility causing discomfort to the patient