In advanced cases of grade II or III furcation involvement, what procedure can improve cleaning and maintenance?

In advanced cases of grade II or III furcation involvement, tunnel preparation is the preferred procedure to improve cleaning and maintenance. This technique involves creating a tunnel-like space within the furcation area, which facilitates access for periodontal cleaning and maintenance. By allowing easier instrumentation of the furcation, tunnel preparation helps to reduce plaque accumulation and improves the overall prognosis of the affected tooth.

The advantage of tunnel preparation lies in its ability to enable regular cleanings by both the patient and the dental professional, which is crucial for managing periodontal disease. It maintains the tooth's structural integrity while providing an essential area for maintenance treatment, especially for teeth that may otherwise be difficult to manage due to accessibility issues inherent in furcation involvement.

Other procedures, while beneficial in certain contexts, do not address the unique cleaning challenges posed by furcation involvement in the same effective manner. Bone grafting is intended to restore lost alveolar bone but does not directly improve cleaning access. Root resection can remove a compromised root but does not create improved access for maintenance. Guided tissue regeneration focuses on promoting the regeneration of periodontal tissues and is not specifically designed to enhance cleaning in furcation areas. Thus, tunnel preparation stands out as the most effective option for enhancing cleaning and maintenance in cases of advanced furcation involvement