Diagnosis and Management of Furcation Lesions in Dogs - A Review

The furcation is the anatomic area where the roots divide on a multirooted tooth. Periodontal disease causing alveolar bone loss can lead to furcation lesions of various stages. Once furcation involvement has occurred, the area can be more difficult to clean or treat due to the complex anatomy and morphology of furcations. Teeth with short root trunks, longer tooth roots, and roots with wide furcation entrance areas/degrees of separation and wide root divergence are considered better candidates for long term maintenance. Dog teeth possess many of these advantageous anatomic features compared to human teeth. Treatment options for teeth with furcation lesions include: closed debridement, open debridement, furcation plasty, tunneling, partial tooth or root resection, root separation (hemisection or trisection), regenerative therapies, or exodontia. There are many factors to consider in determining treatment options. The favorable and unfavorable characteristics for maintenance of teeth with furcation lesions are summarized. Home care and ongoing professional care are important aspects of periodontal disease control for any patient. Studies of systemic and local antibiotic therapies in human patients have not demonstrated reduction of furcation stages, and probiotic effects at furcation sites have not been specifically examined. Human review studies show that most molar teeth once deemed "hopeless" due to stage 3 furcation lesions can be maintained for at least 5 to 15 years with supportive periodontal therapy. Similar long term studies in dogs are needed to improve the evidence-based management of canine patients with furcation lesions.