Picture 1- Normal appearance of restorative to be removed. Sorry my literature review is poor as far as years but there is a great article on location of furcations to CEJ's in the J of Perio I believe 2003. Where the article has great importance is simple. My referrals know that when replacing old restorative on a molar especially with subgingival margins the likely hood of the new margin being located in the furcation is high. TEACH YOUR REFERRALS ABOUT FURCATIONS AND THEIR LOCATIONS TO OLD RESTORATIVE! I suggest strongly evaluating photo #5 and think about what you would do.

Picture 2- Normal appearance of crap under old restorative. Once again great for your referrals to see what lies under the old stuff and why treatment should be considered.

Picture 3- Removal of all decay getting ready to place cores.

Picture 4- Day of surgery with provisionals removed and beautiful cores in place. Provisionals cemented with Durelon as it is anti-microbial thus creating less sensitivity. Provisionals easily removed with Mosquito forceps.

Picture 5- A lot can be learned from this photo for your referrals. Notice location of margin to furcation. It is part of the overhanging lip of the furcation. How are you going to crown lengthen without destroying the furcation? Further if you GO FOR REGENERATION you will only make matters worse and now if you are successful you will have no space for the B.W. Further as I said regeneration in furcations is not predictable which means down the road problems could occur and thus possibly rendering this tooth unfavorable. Also remember as we all know as one crown lengthens a furcation it becomes harder to create a space for the BW as the bone moves coronally the further you go into the tooth.

Picture 6- JUST another option and that is all this is. Remove the old margin and furcation. How do we know when the furcation is gone. Simple. place a probe at the level of the bone and move coronally. When you can move coronally without catching any of the lip of the furcation it is removed.

Picture 7- Occlusal view showing no remaining furcation and old margin removed for 360 degrees. what is the importance of removing the old margin? Now you do not have to use it for CL procedures to create a space for the BW. Simply allow a new BW to establish coronally and wait 14 weeks. Then have your referral place a new margin just coronal to the gingival collar.

Picture 8- Perfect restorative with supragingival margins. Frucations barreled in but frankly should have gone all the way to the occlusal surface. A restorative mistake but we will manage.