Vital root resection of maxillary molars with furcation involvement degree II and/ or III - a randomized, clinical controlled study

• Applicant: Dr. Hari Petsos
• Subject Area: Dentistry, Oral Surgery
• Term: since 2021
• Project identifier: Deutsche Forschungsgemeinschaft (DFG) - Project number 455414030

Root resection is considered to be a valid treatment method for molars in which bone loss has penetrated horizontally into the interradicular furcation area. While furcation involvement with degree I does not restrict the prognosis of the affected tooth, degree II and especially III lead to a deterioration in prognosis. In the classic procedure, it is necessary to treat a tooth endodontically before resection of one of its roots. The consideration of whether this devitalization is necessary before each root resection plays an important role. On the one hand because of the high prevalence of the disease, but also because of the resulting cascade of treatment and the costs for the patient. Normally, several treatment sessions of several hours are necessary for the treatment of a molar. In addition, root canal treatment carries the risk of further complications and often entails prosthodontic care, which in turn is expensive.Maintaining a tooth vital in itself would already be a great advantage, which would be reinforced by saving time and money. Only few data exist dealing with maintaining vitality of molars to be resected (vital root resection) using a mineral trioxide aggregate. Tricalcium silicate has not been clinically investigated for this particular indication. This project is intended to provide additional evidence for both, the use of the material in this indication and for the successful implementation of vital root resections. In this prospective, randomized controlled clinical trial, vital root resections with tricalcium silicate on 76 maxillary molars with grade II or III furcation involvement will be examined using two different approaches:Approach 1: The root is separated under the tooth crown and the very small area of the exposed pulp is covered with tricalcium silicate and composite filling material. Approach 2: The cavum of the crown pulp is opened from the occlusal and the crown pulp is removed. Then the exposed pulp stumps of the roots are covered with tricalcium silicate and the crown is restored with composite filling material.The aim of this randomized clinical trial is to compare both methods for maintaining pulp vitality (positive sensitivity test) of the treated maxillary molars over a follow-up period of 12 months and to confirm the following hypothesis: Vital root resected maxillary molars show comparable sensitivity behavior over a 12-month follow-up, regardless of the approach chosen.

• DFG Programme: Research Grants
• Co-Investigators: Professor Dr. Peter Eickholz; Professor Dr. Stefan Rüttermann