Which treatment is typically NOT recommended for grade III or IV furcation involvement?

In the context of periodontal treatment, grade III or IV furcation involvement indicates significant periodontal disease where there is extensive loss of attachment in the furcation area of a multi-rooted tooth. These grades suggest that the furcation is either partially (grade III) or completely (grade IV) exposed and has a poor prognosis for maintaining periodontal health.

Guided tissue regeneration is a technique that aims to promote the regeneration of periodontal tissues by creating a space around the tooth root for the body to heal. However, in the case of advanced furcation involvement, there may be limited potential for successful regeneration due to the complexity of the anatomical changes, the extent of periodontal destruction, and the factors that contribute to these advanced stages of disease. Additionally, the presence of deep periodontal pockets and inadequate access may further complicate the effectiveness of regenerative procedures in such circumstances.

On the other hand, surgical access is often used in such cases to provide better visibility and the ability to clean the area thoroughly. Extraction can sometimes be necessary, particularly if the tooth is deemed non-restorable. Bone grafting may be utilized to fill the defects and help stabilize the surrounding tissue, although its success can be variable in the presence of severe furcation involvement.

Therefore, the application of guided tissue regeneration