Abstract
This study aimed to evaluate the healing of furcation when repaired with Chitosan (CS) scaffold impregnated or not with Simvastatin (SIM) compared with CollaCote (CL) in goat premolar teeth. Root canal treatment was performed in 52 mandibular premolars followed by furcal perforation induction. The perforation was repaired with CL, CS, or CS with SIM after leaving it untreated for 4 weeks. White mineral trioxide aggregate was carried into the furcal site followed by a 2–3 mm resin-modified glass ionomer. The perforation was left untreated, and the access cavity was left open without coronal filling in the control group. The animals were sacrificed after one and three months. Block sections of the premolars were prepared and examined histologically to evaluate the inflammation and type of healing. Hard tissue formation was found in CL, CS, and CS/SIM groups in both periods. At one month, no significant differences were detected among the experimental groups, whereas at three months, CS without SIM showed significantly better performance compared to CL and CS/SIM groups (p = 0.040). Therefore, repairing furcal perforation with CS scaffolds shows desirable biological responses and healing characteristics in favor of bone regeneration at three months.
Highlights
Furcal perforations are serious complications of iatrogenic errors throughout endodontic access opening or pathological processes that can adversely affect tooth prognosis
The perforation size, location, and time before repair are all noteworthy factors determining the prognosis of perforated teeth [1]
When perforation is not managed promptly, periodontal destruction will occur around the perforation site, resulting in the surrounding bone resorption [2]
Summary
Furcal perforations are serious complications of iatrogenic errors throughout endodontic access opening or pathological processes that can adversely affect tooth prognosis. The perforation size, location, and time before repair are all noteworthy factors determining the prognosis of perforated teeth [1]. MTA is difficult to control and can extrude into the periodontium, especially in large furcal perforations which act as a “bottomless pit” [6] causing mechanical and chemical irritation, triggering tissue inflammation, interfering with the periodontal reattachment, and impairing treatment prognosis [7,8]. Internal matrices have been introduced to restrict MTA overextension [9], and this approach presented favorable outcomes of perforation repair when compared to matrix-free treatment [10]
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