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


METHODS
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.


RESULTS
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.


CONCLUSIONS
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.
Department of Paediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, USP-University of São Paulo, Alameda Dr. Octávio Pinheiro Brisolla, 9-75, Bauru, São Paulo, 17012-901, Brazil.
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NC
Marques
Department of Paediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, USP-University of São Paulo, Alameda Dr. Octávio Pinheiro Brisolla, 9-75, Bauru, São Paulo, 17012-901, Brazil.
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N
Lourenço Neto
Department of Paediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, USP-University of São Paulo, Alameda Dr. Octávio Pinheiro Brisolla, 9-75, Bauru, São Paulo, 17012-901, Brazil. marchini@usp.br.
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TM
Oliveira
D017607:Aluminum Compounds / Q000627:therapeutic use*; D017610:Calcium Compounds / Q000627:therapeutic use*; D002648:Child; D003782:Dental Pulp / Q000187:drug effects; D003786:Dental Pulp Cavity / Q000000981:diagnostic imaging / Q000293:injuries* / Q000473:pathology; D004338:Drug Combinations; D005500:Follow-Up Studies; D005899:Glass Ionomer Cements / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008963:Molar / Q000000981:diagnostic imaging / Q000293:injuries* / Q000473:pathology; D010012:Osteogenesis; D010087:Oxides / Q000627:therapeutic use*; D010483:Periapical Diseases / Q000209:etiology; D011672:Pulpotomy / Q000009:adverse effects; D012387:Root Canal Filling Materials / Q000627:therapeutic use*; D012388:Root Canal Irrigants / Q000627:therapeutic use*; D012390:Root Canal Therapy / Q000009:adverse effects; D017640:Silicates / Q000627:therapeutic use*; D012965:Sodium Chloride / Q000627:therapeutic use; D014092:Tooth Root / Q000187:drug effects / Q000293:injuries; D014094:Tooth, Deciduous / Q000000981:diagnostic imaging / Q000293:injuries* / Q000473:pathology; D014945:Wound Healing
D017607:Aluminum Compounds; D017610:Calcium Compounds; D004338:Drug Combinations; D005899:Glass Ionomer Cements; D010087:Oxides; D012387:Root Canal Filling Materials; D012388:Root Canal Irrigants; D017640:Silicates; C086631:mineral trioxide aggregate; D012965:Sodium Chloride
Furcation; Mineral trioxide aggregate; Tooth; Wound healing
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