UNIVERSITA' DEGLI STUDI DI CAGLIARI
FACOLTA' DI MEDICINA E CHIRURGIA
ISTITUTO DI DISCIPLINE ODONTOSTOMATOLOGICHE
E CHIRURGIA MAXILLO-FACCIALE
SCUOLA DI SPECIALIZZAZIONE IN ODONTOIATRIA E PROTESI DENTALE
Director: Prof. Ignazio MARIA CORTIS
G.PETTI *, I.M.Cortis, C.Cortis
*G.PETTI, Professor of Periodontology, Università di Sassari
Published in May-September 1992
SURGICAL TREATMENT OF 1st, 2nd AND 3rd CLASS LESIONS OF BI- AND TRIFURCATIONS
GUSTAVO PETTI
Physician and Surgeon specializing in Dentistry. Periodontist.
Piazza Repubblica 4, 09129 Cagliari, Italy.
tel ++39 070 498159, fax ++39 070 400164
web site www.gustavopetti.it

Treatment of initial 1st and 2nd class lesions of bi- and trifurcations.

 
Fig. 1. Severely damaged bifurcation of 4.6. The probe penetrates 3 mm at the bifurcation.
Fig. 2. Osteotomy-osteoplastics with rotating instruments for use at a distance from roots.
Fig. 3. Osteotomy-osteoplastics with hand instruments, scalpels, close to roots to recreate festooning.
Fig. 4. Osteotomy-osteoplastics with a file to reconstruct the interradicular furrow as if we were on an interdental platform between two different roots.
Fig. 6. 1st class lesion at the trifurcation of 1.6 - the bifurcation between the palatal root and the mesial vestibular root is involved. There is also a bone defect at the level of the palatal surface of the root of 1.5, it too curable through resective bone surgery.
Fig. 5. Bone remodelling completed: the festoon near the roots has been reconstructed.
Fig. 8. The bone architecture has been restored.
Fig. 7. Osteotomy-osteoplastics with rotating instruments, as if two roots of two different and adjoining teeth were involved
Treatment of advanced 2nd class lesions and of passing 3rd class lesions of bi- and trifurcations.

 
Fig. 9. Serious coronal damage to 4.7 and passing 3rd class damage to the bifurcation.
Fig. 10. After sculpting a mucoperiosteal flap, the roots are separated and a serious interradicular bone defect appears.
Fig. 12. The graft with heterologous Kiel bone, once completed, is shaped and the flap is sutured.odella e si sutura il lembo.

Fig. 11. One proceeds with osteotomy-osteoplastics and an interradicular bone graft to eliminate the defect (Petti, 1987).