Immediate and mediate furcal perforation treatment in primary molars: 24-month follow-up

Eur Arch Paediatr Dent. 2016 Dec;17(6):489-494. doi: 10.1007/s40368-016-0249-5. Epub 2016 Sep 26.

Abstract

Background: Furcal perforation consists of a communication between the pulp cavity and the periodontal tissues that can occur accidentally during cavity preparation or root canal instrumentation. This complication may lead to inflammatory reactions and compromise adjacent tissues irreversibly, resulting in the early loss of primary teeth. Perforation sealing with a biocompatible material is necessary to ensure a favourable prognosis. Among different materials, MTA has been employed due to its excellent healing and physical properties.

Case report: The purpose of these case reports was to describe immediate and mediate cases of furcal perforation treatment using MTA in primary molars. In both the cases, after accidental perforation detection, the pulp chamber was cleaned with saline solution to clear off the debris. The wound surface was continuously irrigated with saline solution and a dry sterile cotton pellet was placed on the radicular pulp stumps and perforation area with slight pressure until the bleeding was controlled. The MTA was applied into the perforation and pulp chamber area with the aid of a sterile amalgam carrier. The teeth were restored with resin-modified glass ionomer cement.

Follow-up: Clinical and radiographic follow-up examinations were carried out at 3, 6, 12, 18, and 24 months after perforation sealing. Both the cases remained asymptomatic, presenting no discomfort, mobility, swelling, or fistula after 24-months follow-up. Radiographically, the radiolucent area disappeared as a result of bone formation in the inter-radicular space, showing adjacent tissue preservation.

Conclusion: Thus, MTA may be considered as an ideal option for conservative treatment of immediate and mediate furcal perforation in primary teeth, once it promoted repair with tooth maintenance in both the cases.

Keywords: Furcation; Mineral trioxide aggregate; Tooth; Wound healing.

Publication types

  • Case Reports

MeSH terms

  • Aluminum Compounds / therapeutic use*
  • Calcium Compounds / therapeutic use*
  • Child
  • Dental Pulp / drug effects
  • Dental Pulp Cavity / diagnostic imaging
  • Dental Pulp Cavity / injuries*
  • Dental Pulp Cavity / pathology
  • Drug Combinations
  • Follow-Up Studies
  • Glass Ionomer Cements / therapeutic use
  • Humans
  • Male
  • Molar / diagnostic imaging
  • Molar / injuries*
  • Molar / pathology
  • Osteogenesis
  • Oxides / therapeutic use*
  • Periapical Diseases / etiology
  • Pulpotomy / adverse effects
  • Root Canal Filling Materials / therapeutic use*
  • Root Canal Irrigants / therapeutic use*
  • Root Canal Therapy / adverse effects
  • Silicates / therapeutic use*
  • Sodium Chloride / therapeutic use
  • Tooth Root / drug effects
  • Tooth Root / injuries
  • Tooth, Deciduous / diagnostic imaging
  • Tooth, Deciduous / injuries*
  • Tooth, Deciduous / pathology
  • Wound Healing

Substances

  • Aluminum Compounds
  • Calcium Compounds
  • Drug Combinations
  • Glass Ionomer Cements
  • Oxides
  • Root Canal Filling Materials
  • Root Canal Irrigants
  • Silicates
  • mineral trioxide aggregate
  • Sodium Chloride