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The severe form of gum disease is called periodontitis. Periodontitis damages the bone that surrounds and supports the teeth. By doing that, periodontitis can change the local anatomy of the jaws:
Periodontitis has caused around this molar both vertical and horizontal bone loss. The vertical loss created a funnel around the back root, while the horizontal loss created a tunnel betweek its 2 roots (deep furcation defect).
Unfortunatley such defects cannot be solved by deep cleaning and intensive use of interproximal brushes. The space of the defect gets quickly filled up by bacteria and inflammation which in the long run make the problem more and more complex.
The solution is a favorable change in the local anatomy by using appropriate surgical techniques.
The funnel shaped defect can be filled up with a mixture of bone particles and a healing booster gel which stimulates the bone cells of the patient to produce new own bone. This technique is called regeneration.
When the horizontal damage between the roots has led to through and through space, it is not possible any more to fill it up. The technique that is relevant in that case, is the tunnel preparation.