Periodontal Regeneration in Class II Furcation Defects: From Regenerative Therapy to Soft-Tissue Management. A Narrative Review

Background

Furcation involvement (FI) represents one of the most challenging conditions in periodontal therapy due to the anatomic complexity of multi-rooted teeth and the progressive interradicular attachment loss that compromises long-term tooth stability. Deep periodontal pockets in molars and premolars often present as combined defects, including horizontal FI and infrabony components. Conventional non-surgical and surgical approaches, including resective procedures, have shown limited long-term advantages, with tooth-survival outcomes comparable to those achieved by open flap debridement. Regenerative strategies, supported by advances in biomaterials, biologic agents, and soft tissue management, have gained increasing interest for Class II and selected Class III defects.