[Conventional surgical furcation therapy. Closed and open scaling].

Epidemiological studies in the sixties indicated that in patients older than 45 years periodontal disease was the major cause of tooth-loss, particularly in molars. However, improved prevention and enhanced dental awareness have now reduced both the incidence of periodontal disease and tooth-loss. Unfortunately, periodontal disease and tooth-loss still progress rapidly in a small group of patients. The currently used diagnostic parameters do not allow the early identification of this small group. Despite controlled periodontal treatment, loss of molars has remained twice as high as overall tooth loss. When all patients are divided into different perio-subgroups, molar loss tends to identify patients with a high periodontal risk. This conclusion can be drawn from the fact that furcation treatment is usually clinically successful, although calculus removal is insufficient. Early diagnosis of molar furcation involvement may help identify the small group of patients in which periodontitis may develop. The local morphological patterns may also contribute to rapid progression of the disease resulting eventually in loss of the molars. In such cases resective therapy is proposed instead of the usual open or closed scaling procedures.