Hemisection
The tooth is divided vertically and horizontally in two equal halves.
Typically, hemisection is done in the lower molars. This procedure is also known as segregation into a single tooth. If there is excessive bone loss, one halve could be extirpated and the other half left behind.
Root Amputation
Root amputation is also a valuable procedure which is applicable to mostly three-rooted maxillary posteriors. It becomes needed where other treatment options are not feasible.
Root ectomy almost always result in irreversible puplal damage; hence, RCT is done first. The coronal part is first with , which is a mixture of various calcium silicates. Sometimes the root resection cannot be made until flaps have been reflected and the periodontal status has been surgically assessed. The rct in such cases could be delayed.
Osseous regeneration procedures such as GTR can be done too.
As for prognosis mostly maxillary first premolar has poor prognosis in most cases;
1- Fusion of roots and furcation area maybe locatetwo equal more apically
2- Roots are located bucally and palatally with furcation opening in a mesiodistal direction
As for maxillary molars, prognosis of furcation involvement is not good enough because the furcation maybe opening bucally, mesially, distally (presence of three roots) making access from proximal areas difficult for plaque control
Mandibular molars on the other hand, have two roots placed distally and mesially and the furcation opens buccolingually
The roots are usually divergent especially the mandibular first molars which makes the prognosis for treatment of mandibular molars better as compared to maxillary molars.
In conclusion, the managements and treatments of furcation involvements are aimed at preventing further attachment losses and improve the maintenance of the furcation areas of multi rooted teeth
The majorly proposed treatment for furcation involvement which has been aforementioned above depends on the nature and extent of the furcation involvement which can be traditional treatment procedures such scaling, root planning, monitoring and evaluation and so on or reconstructive or regeneration treatment by surgical procedures.
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