CASE REPORT Journal of Dentomaxillofacial Science (J Dentomaxillofac Sci ) April 2019, Volume 4, Number 1: 53-56 P-ISSN. 2503-0817, E-ISSN. 2503-0825 53 © 2018 JDMFS. Published by Faculty of Dentistry, Hasanuddin University. All rights reserved. http://jdmfs.org CrossMark Abstr act Objective: A grade II furcation involvement has been defined as a defect having a horizontal loss attachment of 3 mm or greater but not through the entire furcation. There are several techniques used alone or in combination considered to achieve periodontal regeneration. This case report aims to describe regenerative approach in the treatment of grade II furcation defects in maxillary molars. Methods: A 43 years old male reported to the Department of Periodontics with a complaint of pain. At the initial visit, scaling and root planning was done. It was followed by periodontal regenerative therapy using bone graft and resorbable membranes. Results: The treatment for overall seemed success with healthy periodontium and complete closed defect with bone fill, based on the clinical and radiographic development of the patient at the end of six month follow up. Conclusion: The regenerative approach such as resorbable GTR membrane with bone material was more effective than open debridement alone, in the treatment of furcation defects. Keywords: Bone graft, Furcation defect, Guided tissue regeneration, Periodontitis, Periodontal treatment Cite this Article: Thahir H, Setiawati D. 2019. Regenerative approach in the treatment of grade II furcations: a case report. Journal of Dentomaxillofacial Science. 4(1): 53-56. DOI: 10.15562/jdmfs.v4i1.750 Regenerative approach in the treatment of grade II furcations: a case report Hasanuddin Thahir, Dian Setiawati * Introduction Furcation involvement may be defned as the invasion of the bifurcation and trifurcation of multirooted teeth by progression of chronic inflammation during peri- odontitis. 1,2 A study found that furcation involvement is frequently more common in maxillary frst and second molars than mandibular molars. Tis can be explained by the difficulty in accessing the proximal surfaces on maxillary molars for cleaning. 3 Te most common etiologic of furcation involvement is bacterial plaque but there are various predisposing and contributing factors that can aggravate the disease. 4 Te degree of furcation involvement is commonly used as a clinical indicator to qualify the severity of existing periodontal breakdown. Te extent of furcation disease can be determined by evaluating parameters vertical bone loss, horizontal bone loss or both. Most classifcations used to describe the severity of furcation involvement are related to the amount of horizontal attachment loss. 5,6 Glickman has suggested the classifcation into grade I, grade II, grade III and grade IV. 7 Grade II furcation lesion is a culdesac with a defnite horizontal component. Te horizontal loss of periodontal tissue support >3 mm but not through-and-through defect. 8,9 Te treatment and management of teeth with furcation involvement presents one of the greatest challenges in periodontal therapy. 10,11 Te therapy of furcation involvement depends primarily on the extent of the disease, the strategic importance of the afected tooth and on the degree of patient cooperation and compliance. Terapies must begin with the initial periodontal treatment (systemic and cause-related phases) followed by debridement to regenerative procedures and extraction if the lesion progresses. However, the treatment must be sustained by the adequate hygiene of the patient, and by the close monitoring of the clinician 12 Elimination of the pocket by resective or regener- ative procedures and making the area accessible for plaque control is the primary objective of any furcation therapy. 13 Tere are several techniques used alone or in combination, which are considered to achieve periodontal regeneration, including bone grafs or substitutes, guided tissue regeneration, root surface modifcation and biological mediators. 14 More recently, techniques aimed at using bone grafs and/or barrier materials have been evaluated in regenerating furcation defects grade II. 9 An important objective of regenerative therapy has been a predictable clinical course of furcation defects afer periodontal regeneration, as evidenced by the formation of a new attachment apparatus including bone, cementum and periodontal liga- ment. 15 Periodontal surgery using guided tissue regeneration (GTR) using non resorbable membran and bioabsorbable barriers has been widely used to regenerate bone and establishing a new connective tissue attachment. 16 One of the most important indications for GTR treatment is the class II furca- tion defect. Bone graf are widely use to promote Department of Periodontic, Faculty of Dentistry, Hasanuddin University, Makassar Indonesia * Corresponding to: Dian Setiawati, Department of Periodontic, Faculty of Dentistry, Hasanuddin University, Makassar Indonesia setiawatidian44@gmail.com Received: 10 June 2018 Revised: 15 June 2018 Accepted: 9 July 2018 Available Online 1 April 2019