How to deal with a furcation when your crown margin is deep

We all know and understand biologic width and its relationship to restorative dentistry. When a restorative margin is too deep, it becomes a source of chronic inflammation. How often have we removed an old crown on a molar and the caries progresses sub-gingivally? To the point of the furcation on a molar? We know we can’t end our new margin that close to the bone and we know we don’t our new margin on the roof of a furcation. Traditionally, this indicated crown lengthening. However, crown lengthening a molar with a high branching furcation would only open up the furcation more and downgrade the prognosis of the tooth to poor or hopeless.

Biologic shaping reverses this problem. Instead of moving the bone away from the margin, the reshaping and elimination of the margin all the way to the crest of bone allows for a newly coronally positioned margin. Moving the margin away from the bone instead of moving the bone away from the margin. A biologically sound way to save teeth.