Histological evaluation of contaminated furcal perforation in dogs’ teeth repaired by MTA with or without internal matrix

Abstract

Perforation is a communication between the root canal system and the surrounding tissues through the floor of the pulp chamber or root canal wall of the tooth. 1 Sinai I. Endodontic perforations: their prognosis and treatment. J Am Dent Assoc. 1977; 95: 90-95 Google Scholar , 2 Jew R. Weine F. Keen J. A histologic evaluation of periodontal tissues adjacent to root perforations filled with Cavit. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1982; 54: 124-135 Google Scholar It can occur as a result of a large carious lesion in or adjacent to the floor of the pulp chamber, internal or external root resorption, and during endodontic treatment or after space preparation. The long-term prognosis of a perforated tooth is dependent upon the location of the perforation, how long the perforation is exposed to oral contamination, and the ability to seal the perforation. 1 Sinai I. Endodontic perforations: their prognosis and treatment. J Am Dent Assoc. 1977; 95: 90-95 Google Scholar Experimental studies of periodontal tissue reaction after perforations in monkeys’ and in dogs’ teeth, together with some clinical investigation of perforations in human teeth, suggest that perforation in the cervical third of the root or in the floor of the pulp chamber have the least favorable prognosis after treatment. 3 Seltzer S. Sinai I. August D. Periodontal effects of root perforations before and during endodontic procedures. J Dent Res. 1970; 49: 332-339 Google Scholar , 4 Meister F. Lommel T. Gerstein H. Davies E. Endodontic perforations which resulted in alveolar bone loss. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1979; 47: 463-470 Google Scholar These types of perforation usually increase the possibility of epithelial proliferation and periodontitis. 1 Sinai I. Endodontic perforations: their prognosis and treatment. J Am Dent Assoc. 1977; 95: 90-95 Google Scholar , 5 Lantz B. Persson P. Periodontal tissue reactions after surgical treatment of root perforations in dog’s teeth: a histologic study. Odont Revy. 1970; 21: 51-62 Google Scholar Nonsurgical immediate repair using proper filling material may prevent the resulting communication between perforation site and gingival sulcus and thus favorable prognosis could be achieved. 6 Lemon R. Nonsurgical repair of perforation defects. Dent Clin North Am. 1992; 36: 349-457 Google Scholar Amalgam has been the standard material for repairing furcal perforation for many years. 7 El Deeb M.E. El Deeb M. Tabibi A. Jensen J. An evaluation of the use of amalgam, Cavit and calcium hydroxide in the repair of furcation perforation. J Endod. 1982; 8: 459-466 Google Scholar , 8 Balla R. LoMonaco C. Skribner J. Lim L. Histological study of furcation perforation treated with tricalcium phosphate, hydroxyapatite, amalgam, and life. J Endod. 1991; 19: 591-595 Google Scholar Recently, mineral trioxide aggregate (MTA) material was found to be superior to most of the dental materials that have been tried to repair furcal perforation. 9 Pitt Ford T. Torabinejad M. Hong C. Kariyawasam S. Use of mineral trioxide aggregate for repair of furcal perforations. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1995; 79: 756-763 Google Scholar , 10 Weldon J. Pashley D. Loushine R. Weller R. Kimbrough W. Sealing ability of mineral trioxide aggregate and Super-EBA when used as furcation repair materials, a longitudinal study. J Endod. 2002; 28: 467-470 Google Scholar