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Furcation Involvement — ORE Part 1 MCQ

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ModeratePeriodontologyFurcation InvolvementORE Part 1

A 50-year-old man with well-controlled hypertension on amlodipine presents with food packing between the lower right second premolar and first molar. Examination reveals grade II furcation involvement of the first molar. According to current UK BSP guidelines for managing periodontitis, what treatment approach is indicated for this tooth?

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Correct answer: A — Step 2: cause-related non-surgical therapy with subgingival instrumentation and furcation assessment

Explanation lettering: D = shown as B · E = shown as D · B = shown as E

Grade II furcation involvement in the context of active periodontitis (evidenced by food packing and furcation probing) requires Step 2: cause-related non-surgical therapy (A). UK guidance recommends non-surgical treatment for Grade II furcation defects, with subgingival instrumentation as the cornerstone of management. While Step 1 (behaviour change) is essential and concurrent, it is insufficient as the sole treatment strategy for active disease. Option C (surgical management) is not first-line for Grade II lesions; evidence shows comparable outcomes between surgical and non-surgical approaches, with non-surgical being preferred initially. Option D represents maintenance therapy following disease stabilisation. Option E is incorrect as extraction is not indicated for Grade II involvement and represents harmful overtreatment.

Reference: SDCEP (Scottish Dental Clinical Effectiveness Programme). Prevention and Treatment of Periodontal Diseases in Primary Care. Second edition, 2021. Section: Furcation involvement. https://www.periodontalcare.sdcep.org.uk/guidance/managing-disease/periodontitis/furcation-involvement/