Furcation Perforations Research Articles

Effect of pulpal floor perforation repair on biomechanical response of mandibular molar: A finite element analysis.

Background:Evaluation of the biomechanical response of tooth with perforation repair is important to attain predictable prognosis. It may remain altered even after perforation repair due to the loss of tooth structure.Aim:The aim of this study is to assess and compare the effect of pulpal floor perforation repair of different sites with biodentine, on the biomechanical response of mandibular molar through 3-dimensional (3D) finite element analysis (FEA).Materials and Methods:Five different 3D models were constructed based on the site of perforation on the pulpal floor using cone-beam computed tomographic images of an extracted mandibular molar. Perforation size was standardized and simulated to be repaired with calcium silicate-based cement. A force of 200 N was applied simulating normal occlusal loads. Static linear FEA was performed using the Ansys FEA software. Tensile stresses were evaluated (Pmax).Statistical Analysis Used:The data were evaluated using the independent t-test (P = 0.05).Results:All the simulated models with perforation repair exhibited higher stress values than their equivalent sites in the control group. The Pmax values of the repaired models were highest in central furcal perforation, followed by buccal furcal perforation. However, there was no statistically significant difference in the stress accumulation among the different repaired perforation sites.Conclusion:The site of the pulpal floor perforation affected the stress distribution and accumulation. Central and buccal furcal perforation repairs on the pulpal floor with calcium silicate-based cement in mandibular molar are likely to have an increased risk of fracture.

Comparison of Sealing Efficiency of Mineral Trioxide Aggregate and Biodentine used in Perforation Repair in Acidic and Neutral Environments- An In-vitro Study

Introduction: Furcation perforation is one of the complications that occur during endodontic treatment due to anatomical differences or iatrogenic causes. Repairing the perforation with a biocompatible material eliminates the connection with the gingival sulcus and positively affects the prognosis. The sealing ability of the repair materials is very important and is affected by the conditions of the environment in which they are applied. Aim: To compare the sealing efficiency of Mineral Trioxide Aggregate (MTA) (Angelus, Londrina, PR, Brazil) and Biodentine (Septodont, Saint Maur des Fosses, France) materials used in the repair of furcation perforations in acidic and neutral environments. Materials and Methods: This in-vitro experimental study was carried out in the Department of Endodontics at Dicle University Faculty of Dentistry, Diyarbakır, Türkiye and Dicle University Science and Technology Application and Research Center from 10th June 2020 to 22nd July 2020. A total of 96 mandibular molars were used in the study. The specimens were randomly divided into two equal groups (n=48). When the perforations were repaired with MTA and Biodentine materials, each group was divided into four subgroups (n=12). These subgroups were kept in Phosphate Buffered Saline (PBS) and Acetic Acid (AA) solutions for different periods of time from 4 or 34 days, and all groups were immersed in methylene blue solution. The dye penetration level of the divided sections was examined under a stereomicroscope (Leica, Wetzlar, Germany). Microleakage data of all groups were statistically analysed using Kolmogorov Smirnov, Shapiro Wilk’s and Mann-Whitney U Test. Statistical significance was set at 0.05, it was stated that there was a significant difference when p-value <0.05. Results: The short-term (4 days) microleakage level of biodentine material in the AA environment was significantly lower than that of MTA material (p-value=0.005). There was no statistically significant difference between the materials in terms of long-term (34 days) microleakage levels in the AA environment (p-value >0.05). The long-term microleakage level in PBS environment of biodentine material was significantly lower than that of the AA environment (p-value=0.008). Conclusion: Lower microleakage levels were observed in the neutral environment than the acid environment with both MTA and biodentine during both holding periods.

Effect of blood contamination and various hemostatic procedures on the push-out bond strength of Biodentine when used for furcation perforation repair.

Background:Perforations in the furcation area are common procedural accidents that can impact the outcome of treatment. There are many bioactive materials available to repair these defects.Aim:The purpose of this study was to determine and compare the effect of 25% aluminum chloride solution, 20% ferric sulfate solution, and a 980-nm diode laser, when used for hemostasis, on the dislocation resistance of Biodentine placed to repair furcation perforation.Materials and Methods:This in vitro study was conducted on fifty extracted human permanent mandibular molars, with ten teeth in each group. The stimulated perforations were contaminated with blood, except for one group. The contaminated groups were either treated with aluminum chloride, ferric sulfate, diode laser, or none at all. All the perforations were restored with Biodentine and tested for push-out bond strength.Statistical Analysis Used:One-way analysis of variance and Tukey's HSD post hoc test were applied with a level of significance set at 0.05.Results:The dislocation resistance of Biodentine was found to be highest when aluminum chloride or diode laser was used for arresting bleeding. In contrast, the ferric sulfate group gave the lowest value for push-out bond strength (P < 0.05).Conclusions:According to the present study, the use of ferric sulfate as a hemostatic agent showed a negative effect on the bond strength of the calcium silicate cement to dentin. Furthermore, Biodentine performed better when diode laser and aluminum chloride were used for hemostasis.

Non-surgical Furcal Perforation Management with Biodentine in Retreatment: A 1-Year Recall Review

Furcal perforation management in root canal retreatment is often challenging as the outcome of the perforation sealing depends on several parameters. The recent introduction of several bioactive cements and magnification systems has made the sealing of perforations easier and the outcome more predictable. This study highlights the clinical outcomes of furcal perforation management in root canal retreatment using biodentine.

Evaluation of the visibility of the materials used in furcation perforation in imaging devices

Background:Two-dimensional radiographic techniques are difficult to diagnose in the diagnosis of furcation perforations because of the projection geometry and the anatomical structures’superposition problems. Cone Beam Computed Tomography (CBCT) is more accurate diagnostic modality than conventional imaging methods due to the lack of superposition and lack of magnification.Methods:In this study, 114 lower molar teeth were selected. Biodentin, BioAggregate, BioCeramix, MTA and Endosequence were placed to repair the perforation zone. Periapical radiographs were obtained with Sorodex Digora Optime with phosphorous plaques, other radiographic images were obtained using Planmeca Dixi 3 CCD, while KIBT images were obtained using Morita Veraviewepocs 3D R100. An endodontist and two dentomaxillofacial radiology specialists examined the CBCT images and periapical radiographs.Results:MTA and Biodentine were found to have low image quality, Bioaggregate and Endosequence high image quality. Morita Veraviewepocs 3D R100 showed the highest sharpness, but no difference was observed between Sorodex Digora Optime and Planmeca Dixi 3 devices.Conclusions:Cone Beam Computed Tomography (CBCT) imaging is a superior method in the diagnosis of endodontic furcation perforations compared to two-dimensional methods.Keywords:Cone-Beam Computed Tomography, endodontics, furcation defects

Evaluation of Stress Distributions in Mandibular Molar Teeth with Different Iatrogenic Root Perforations Repaired with Biodentine or Mineral Trioxide Aggregate: A Finite Element Analysis Study

IntroductionIn this study, finite element analysis was used to evaluate the stress distributions in simulated mandibular molar teeth with various iatrogenic root perforation types after reparation with Biodentine (Septodont, Saint-Maur-des-Fossés, France) or mineral trioxide aggregate (MTA). MethodsAn extracted human mandibular molar tooth was scanned using a micro–computed tomographic device, and a 3-dimensional solid model was created. Then, 3 different iatrogenic perforation types (furcation perforation [FP], strip perforation [SP], and post drill perforation [PDP]) and 2 different repair materials (MTA and Biodentine [BD]) were simulated on the model. In addition, a sound tooth (ST) model (control) and a model left unrepaired for each type of perforation were created; then, access cavities were restored using resin composite, except for the sound tooth model. Consequently, a total of 10 experimental models were designed. An oblique force of 300 N angled at 45° to the occlusal plane was simulated. Evaluations of von Mises stress were performed in the perforated regions. ResultsMaximum von Mises stress values were 7.76 MPa for ST/corresponding to the FP region, 8.48 MPa for ST/corresponding to the SP region, 14.20 MPa for ST/corresponding to the PDP region, 10.89 MPa for FP /MTA, 7.65 MPa for FP/BD, 14.67 MPa for FP/unrepaired, 15.92 MPa for SP/MTA, 15.82 MPa for SP/BD, 21.95 MPa for SP/unrepaired, 10.20 MPa for PDP/MTA, 9.17 MPa for PDP/BD, and 17.86 MPa for PDP/unrepaired. ConclusionsThe results of this finite element analysis indicated that BD models showed lower maximum von Mises stress values than the MTA models, and SPs exposed higher stress concentrations in root perforation regions than FPs and PDPs. The use of MTA and BD may reduce the risk of potentially harmful stress in root perforation regions.

Marginal adaptation, solubility and biocompatibility of TheraCal LC compared with MTA-angelus and biodentine as a furcation perforation repair material

BackgroundThis study evaluated the marginal adaptation, solubility and biocompatibility of TheraCal LC compared with mineral trioxide aggregate (MTA-Angelus) and Biodentine when used as a furcation perforation repair material.MethodsThe marginal adaptation was assessed by scanning electronic microscope and presence of any gap between the dentin surface and filling material in each quadrant of the sample was analyzed at 1000 X magnification. The solubility was measured after one week by the ISO standard method. Biocompatibility was evaluated by the inflammatory response and radiography after one month and three months of repair of experimental furcation perforations in dog's teeth.ResultsThere were significant differences in the marginal adaptation, solubility and biocompatibility of the tested materials (P < 0.05). TheraCal LC showed the highest frequency distribution of gap presence that was followed by the MTA-Angelus then Biodentine. The least soluble material after one week was TheraCal LC that was followed by the MTA-Angelus and Biodentine. After one month and three months, TheraCal LC showed the highest inflammatory response and highest frequency distribution of radiolucency that was followed by the Biodentine then MTA-Angelus.ConclusionUnlike Biodentine, TheraCal LC is incapable of alternating the MTA in furcation perforation repair due to its poor biocompatibility and poor marginal adaptation.

Evaluation of Sealing Ability of Biodentine and Mineral Trioxide Aggregate in Permanent Molars using Dye Extraction Method-an Invitro Study

Objective: The aim of this study was to compare the sealing ability of MineralTrioxide Aggregate (MTA) and Biodentine when used to repair the furcal perforations in permanent molars using dye extraction method. Study design: Recently extracted permanent molars were collected and randomly sealed with MTA and biodentine, after preparing perforations in the furcation area by using a high-speed long shank round bur No:4. After setting of the material, specimens were kept in methylene blue dye for 24 hours to check the microleakage by the dye extraction method. Samples were then placed in vials containing 1ml of 65% nitric acid for three days for the extraction of the dye. The vials were centrifuged at 14000 rpm for 5 minutes to separate debris from the extracted dye. About 200 microlitres of the supernatant from each sample was then analyzed in a UV-visible spectrophotometer at 550nm wavelength using concentrated nitric acid as the blank, and readings were recorded as absorbance units.

Sealing Ability of Mta Vs Biodentine In Repair of Furcal Perforation of Primary Molars: An In Vitro Study

Sealing Ability of Mta Vs Biodentine In Repair of Furcal Perforation of Primary Molars: An In Vitro Study

A Silk Fibroin Based Hydration Accelerator for Root Canal Filling Materials.

Mineral trioxide aggregate (MTA) is widely used in various dental endodontic applications such as root-end filling, furcal perforation repair, and vital pulp therapy. In spite of many attempts to improve handling properties and reduce the discoloration of MTA, the ideal root canal filling material has yet to be fully developed. The objective of this study was to investigate the setting time, mechanical properties, and biocompatibility of MTA set by a silk fibroin solution. A 5 wt% silk fibroin (SF) solution (a novel hydration accelerant) was used to set SavDen® MTA and ProRoot® white MTA (WMTA). Changes in setting time, diametral tensile strength (DTS), material crystallization, in vitro cell viability, and cell morphology were assessed by Vicat needle measurement, a universal testing machine, scanning electron microscopy (SEM), and WST-1 assay, respectively. The initial setting time of ProRoot® MTA and SavDen® MTA experienced a drastic decrease of 83.9% and 42.1% when deionized water was replaced by 5 wt% SF solution as the liquid phase. The DTS of SavDen® MTA showed a significant increase after set by the SF solution in 24 h. A human osteoblast-like cell (MG-63)-based WST-1 assay revealed that both ProRoot® MTA and SavDen® MTA hydrated using SF solution did not significantly differ (p > 0.05) in cell viability. MG-63 cells with pseudopodia attachments and nuclear protrusions represent a healthier and more adherent status on the surface of MTA when set with SF solution. The results suggest that the 5 wt% SF solution may be used as an alternative hydration accelerant for MTA in endodontic applications.

Accuracy of Conventional Periapical Radiography in Diagnosing Furcation Repair after Perforation Treatment

IntroductionPeriapical radiography (PR) is a diagnostic tool to be used by professionals in clinical practice. The method presents limitations, and doubts still exist about its value to evaluate furcation perforation and the reparative process of hard or soft tissues after treatment. Thus, the aim of this study was to evaluate the accuracy of PR as a diagnostic method to detect both resorption of the furcation area after induced experimental perforation and repair after perforation treatment using histopathological findings as a gold standard. MethodsThirty teeth of beagle dogs with furcation perforation were filled with Biodentine (Septodont, Saint-Maur-des-Fossés, France), ProRoot White mineral trioxide aggregate (Dentsply Tulsa Dental Specialties, Tulsa, OK), or gutta-percha and examined using PR and histology. Sensitivity, specificity, predictive values, and accuracy were calculated. ResultsPR detected repair and reabsorption of furcation perforation in 55% and 48% of the teeth, respectively. Histologic analysis showed furcation perforation in 66% and 21% of the teeth, respectively. Sensitivity and specificity of PR for the detection of repair were 0.84 and 1, respectively, whereas for resorption detection, the values were 0.43 and 0.65, respectively. Diagnostic accuracy for PR was 0.89 and 0.72 for repair and resorption of furcation perforation, respectively. PR showed more accurate diagnostic (true positives + true negatives/total) in repair detection compared with resorption of furcation perforation. ConclusionsWe conclude that PR is not adequate in detecting resorption progress after the treatment of furcation perforation, and we encourage the use of digital imaging when suspicious of a possible unsuccessful result after furcation perforation treatment.

EVALUATING SEALING ABILITY OF THREE DIFFERENT FURCATION PERFORATION REPAIR MATERIALS

Introduction Keeping up the uprightness of the characteristic dentition is basic for completely utilitarian and tasteful conditions. Technical issues do happen once in a while during endodontic treatment, one of which is puncturing of the root waterway divider. This can altogether affect the drawn out visualization of the tooth. Aim To study evaluating sealing ability of three different furcation perforation repair materials. Materials And Methods Recently extracted mandibular molar teeth collected from the Department of Oral and Maxillofacial Surgery, faculty of Dental Sciences, Krishna Institute of Medical Sciences, Karad. The scores for microleakage were tested for normality using ShapiroWilk test. The normality of the data for microleakage scores was rejected hence Kruskall-Wallis test has been used to compare the scores between the three groups (perforation repair materials) followed by Mann-Whitney U test for individual comparisons Observations And Results 80% of the samples showed no leakage in MTA material, 5% of the samples showed no leakage in light cured GIC material and 90% of the samples showed no leakage in Biodentine material. Pair wise comparison -A significant difference is observed between MTA and light cured GIC materials with respect to dye penetration (U=20.00, p

Radiographic evaluation of the quality of root canal treatment in a Bangladeshi population

Background and objective: Root canal treatment (RCT) has a high rate of success, when performed by properly trained dental surgeons. However, the failure rate is inappreciably high when the same procedure is done by less experienced dental graduates having no specialization on endodontics. This study was conducted to evaluate the technical quality of RCT performed by practicing dental graduates on Bangladeshi patient.&#x0D; Methods: This cross-sectional study was conducted in the Department of Dentistry of BIRDEM General Hospital Dhaka over a period of 6 months from January to June 2019. Radiographs of patients who had undergone RCT in last 6 months were included in the study. Parameters used to evaluate the obturation of the root canal were presence of root-filled, posts and voids. The RCT was assessed for filling at the end of the root with radiographic apex, the density of the filling material and taper from the orifice to apex. The quality of RCT was evaluated as totally unacceptable (score: 0-2), poorly acceptable (score: 3-4), acceptable (score: 5) and perfect (score: 6) based on the treatment score. Post-treatment complications were determined by furcation and cavity wall perforation, transportation, root perforation, instrument breakage, ledge formation, voids and missed canal.&#x0D; Result: A total of 180 postoperative readable radiographs with post root-canal treatment were evaluated. Evaluation of the technical quality of RCT revealed that 56% of the RCTs were of standard quality (41.7% were of perfect quality and 14.4% were of acceptable quality). The rest 23.3% were poorly acceptable and 20.6% were totally unacceptable. Majority (92.8%) of the obturation of the root canal revealed that roots were filled with sealing materials; however, 8.9% exhibited posts and 36.7% demonstrated voids. A sizable portion of the root canal obturation was unacceptable in terms of its length (12.2%), density (20%) and tapering (16.7%). Total 132 (73.3%) teeth developed at least one complication. Under filling and voids were predominant complications (42.8% and 41.1% respectively) followed by root perforation (12.2%), transportation (11.7%), ledge formation (5%), instrument breakage (2.8%) and missed canal (3.3%).&#x0D; Conclusion: The study concluded that over forty percent of the RCTs performed by dental graduates having no specialization on endodontics are of substandard quality and hence not acceptable.&#x0D; Ibrahim Med. Coll. J. 2019; 13(2): 59-64

Sealing Ability of Calcium Silicate-based Materials in the Repair of Furcal Perforations: A Laboratory Comparative Study

To assess the sealing ability of two calcium silicate-based materials in the treatment of iatrogenic furcal perforations using a dye-penetration leakage model. Furcation perforations were performed using a size 12 round burr on the pulp chamber floor of 20 first mandibular molars. The teeth were then randomly divided into two groups, two additional molars served as negative controls. The defects were then filled with mineral trioxide aggregate (MTA) Angelus in the first group and Biodentine in the second group. Leakage at the repaired sites was then evaluated using the methylene blue dye penetration technique. Significant differences in microleakage were found between the two groups at 72 hours (p < 0.001). MTA Angelus had greater dye penetration than Biodentine with a statistically significant difference. Subsequently, the sealing ability of Biodentine was significantly better than MTA Angelus (p < 0.001). However, the mean values of leakage and inadequate adhesion were significantly different from the theoretical value for both the MTA Angelus (p < 0.001) and Biodentine (p < 0.001). The current results suggested that Biodentine possesses higher sealing quality than MTA Angelus. Yet, both materials are not ideal and still need improvement to ensure perfect adhesion in case of furcal perforation. This article aims to compare the sealing ability of one dental repair material over another, after iatrogenically producing a furcal perforation. Leakage resistance and sealing ability are important factors in favoring the outcome of an endodontic treatment of a tooth that could otherwise be condemned for extraction.

Sealing ability of three different root repair materials for furcation perforation repair: An in vitro study.

Aim:The present study aimed to evaluate and compare the sealing ability of mineral trioxide aggregate (MTA)-Angelus, Biodentine™, and EndoSequence cement in furcation perforations using protein leakage assessment.Materials and Methods:The present study was conducted using seventy extracted human maxillary and mandibular molars with intact furcation. The samples were randomly allocated into three groups (n = 20) based on repair material used: Group 1 – MTA-Angelus, Group 2 – Biodentine™, and Group 3 – EndoSequence. Two additional groups served as positive and negative controls (n = 5). Using the leakage assessment apparatus, the presence of protein was detected with a reagent (Coomassive Brilliant Blue) every day for 60 days. One-way ANOVA and post hoc Tukey's test were used for statistical analysis using SPSS software.Results:All the groups exhibited protein leakage from day 1. Biodentine showed minimum (0.1201 mg/ml), MTA showed maximum (0.3738 mg/ml), and EndoSequence had intermediate (0.2465 mg/ml) leakage. None in the negative control and all of the positive control specimens leaked during the experimental period of 60 days.Conclusion:The newer biomaterials, Biodentine and Endosequence with better handling properties, could be used as alternatives to MTA-Angelus while repairing furcation perforations.

Comparative evaluation of sealing ability of two different biocompatible materials in repair of furcal perforation: An In vitro study

Purpose: The purpose of this study was to evaluate the sealing ability and microleakage of Biodentine and mineral trioxide aggregate (MTA) Repair HP as furcal perforation repair materials. Materials and Methods: Twenty permanent mandibular molars were divided for ten samples each in Group I – Biodentine and Group II – MTA Repair HP. After access cavity preparation, artificial perforation was created and sealed with the repair material. Specimens were suspended in 2% methylene blue dye for 24 h and then split into longitudinal sections. After examining the depth of dye penetration under stereomicroscope, microleakage was calculated. Results: A higher mean microleakage was recorded in MTA Repair HP as compared to Biodentine. Conclusion: The study showed that Biodentine shows maximum sealing ability and least microleakage when compared with MTA Repair HP.

Histologic Evaluation of Artificial Floors Under MTA and Nano-Filled Resin-Modified Glass Ionomer Used to Repair Furcation Perforations in Dogs.

Objective:This study aimed to compare the tissue reaction of two repair materials for furcation perforations, nano-filled resin modified glass ionomer (Nano-FRMGI) and mineral trioxide aggregate (MTA), used with or without an artificial floor.Methods:A total of 96 teeth in 6 dogs were used for this study. After access cavities, root canals were prepared and obturated with gutta percha using cold lateral condensation technique. Perforations were then created on the floors of the pulp chambers. The perforations divided into four groups n=24/group that were sealed with MTA alone, MTA with calcium sulphate artificial floor (CSAF), FRMGI alone and Nano-FRMGI with CSAF. All access cavities were filled with composite resin. Two dogs were sacrificed at 1, 3, and 6 month. The experimental tooth along with the surrounding alveolar bone were cut in block sections and histologically evaluated for tissue response. Data were analyzed by Chi-square (P≤0.05).Results:MTA and MTA with CSAF showed more bone and cementum apposition when compared to Nano-FRMGI at 6-month interval. MTA and MTA with CSAF showed less bone resorption, epithelium proliferation and inflammation compared to Nano-FRMGI at 6-month interval.Conclusion:MTA with CSAF or MTA-alone show better outcomes in the repair of pulp chamber floor perforation.

A comparative evaluation of sealing ability of three perforation repair materials using a field emission gun-scanning electron microscope

Introduction: The study aimed to assess the sealing ability of Biodentine™, ProRoot mineral trioxide aggregate (MTA), and Super-EBA as furcation perforation repair materials using field emission gun-scanning electron microscope (FEG-SEM). Materials and Methods: Thirty-six extracted human permanent mandibular molar teeth were collected and cleaned. Standard access cavity preparation was made, and intentional perforation was created in each of the access cavity-prepared teeth using #12 round bur. The teeth were randomly divided into three groups each containing 12 teeth. The perforations were sealed as follows: Group A with Biodentine™, Group B with ProRoot MTA, and Group C with Super-EBA. The repair materials for all the three groups were evaluated for marginal adaptation using FEG-SEM. Data were statistically analyzed using one-way ANOVA and Tukey's honest significance test. Results: Quantitative FEG-SEM observations illustrated that the mean gap at the dentin–furcation repair material interface was as follows: Biodentine (3.01 ± 0.37 μm), ProRoot MTA (4.98 ± 0.68 μm), and Super-EBA (8.03 ± 0.68 μm). The difference between Biodentine™ and ProRoot MTA was not statistically significant (P > 0.05). Individually, Biodentine and ProRoot MTA showed statistically significant differences when compared to Super-EBA (P Conclusion: The sealing ability of ProRoot MTA and Biodentine™ as a repair material of furcation perforation was better than Super-EBA.

Comparative evaluation of effect of chloroquick irrigating solution on push-out bond strength of endoseal mineral trioxide aggregate and endosequence root repair material when used as furcal perforation repair material: An in vitro study.

Aim:The purpose of this study was to comparatively evaluate the effect of Chloroquick irrigating solution on push-out bond strength of Endoseal mineral trioxide aggregate (MTA) and endosequence root repair material (ERRM) when used as furcal perforation repair materials.Materials and Methods:Forty human extracted mandibular molars were collected. A standardized endodontic access cavity was prepared in 40 samples, and intentional perforation of 1.32 mm in diameter was created on the pulpal floor. Teeth were randomly divided into four groups: Group A: EndoSeal MTA with irrigation, Group B: ERRM with irrigation, Group C: EndoSeal MTA without irrigation (Control group), and Group D: ERRM without irrigation (Control group). The samples were subjected to universal testing machine then examined under a stereomicroscope at × 40 to determine the nature of the bond failures.Results:EndoSeal MTA with Chloroquick irrigating solution irrigation showed the highest push-out bond strength (MPa) with a statistically significant difference among all the groups (P = 0.003). The majority of the samples exhibited cohesive and mixed types of failures.Conclusion:Chloroquick irrigating solution irrigation has no adverse effect on the push-out dentin bond strength of Endoseal MTA and ERRM.

Conventional flap versus laser assisted periodontal surgery in the treatment of furcal abscess- a case report.

Introduction: Furcal perforations compromise the health of the periradicular tissues and threaten the viability of the tooth. Perforation repair is a very attractive and frequently successful alternative to extraction of the involved tooth. Diagnosis and repair of furcal perforation, abscess have remained a diagnostic and therapeutic dilemma for the clinician. We believe this case report is the first of its kind to compare the repair of furcal perforation due to iatrogenic causes with mineral trioxide aggregate (MTA) and bone graft by conventional surgical technique and laser assisted periodontal therapy in mandibular molars. Case presentation: Two patients presenting with clinical presentation and diagnosis of furcal abscess due to iatrogenic causes were treated and followed up for six months. The furca were exposed surgically. The furcation area in one patient was debrided by conventional periodontal therapy while in the other laser assisted periodontal therapy was instigated using diode laser, and the perforation sealed with mineral trioxide, bone graft was placed in the interradicular area. Clinical and radiographic examinations were conducted at base line and 6 months. Conclusion: During the 6 month follow up satisfactory resolution of the clinical and radiographic defect in the interradicular region was achieved by both conventional surgical and laser assisted periodontal therapy. Keywords: furcal abscess, perforation repair, mineral trioxide, diode laser, bonegraft