Journal of Scientific Dentistry

Register      Login

VOLUME 13 , ISSUE 2 ( July-December, 2023 ) > List of Articles


Radiographic Evaluation of Furcal Perforation Repair Using e-MTA® in Primary Molars-90 Days Follow-up: A Case Report

Abhinandan Patra, Sonal Gupta, Abia Baby

Keywords : Case report, Mineral trioxide aggregate, Perforation, Primary teeth, Pulpectomy

Citation Information : Patra A, Gupta S, Baby A. Radiographic Evaluation of Furcal Perforation Repair Using e-MTA® in Primary Molars-90 Days Follow-up: A Case Report. 2023; 13 (2):48-51.

DOI: 10.5005/jp-journals-10083-1044

License: CC BY-NC 4.0

Published Online: 23-11-2023

Copyright Statement:  Copyright © 2023; The Author(s).


Introduction: Iatrogenic furcation perforation is an unintended communication between the pulp chamber and the periodontal tissues that can occur during root canal therapy or while locating the root canal orifices. Management of these iatrogenic mishaps especially in primary teeth can be challenging. Recent advancements in the techniques and materials used to repair furcal perforations have improved the outlook for this procedure. Recently, mineral trioxide aggregate (MTA) has been used for several dental purposes. This biocompatible material promotes bone healing and the elimination of clinical symptoms. Case description: The purpose of this case report is to describe the treatment of an iatrogenic furcal perforation using MTA in a primary first molar tooth of an 8-year-old boy patient who had reported a chief complaint of pain in the lower left back tooth region for the past 3 weeks. Clinical examination revealed carious lesions involving enamel, dentin, and pulp in relation to 84. Intra-oral periapical radiograph revealed well-defined radiolucency involving enamel dentin and pulp. The treatment plan was non-vital pulp therapy: Pulpectomy. Following the access cavity preparation, even after debridement and cleaning of pulp from the root canals, there was profuse bleeding in the access cavity. Furcal perforation was confirmed with a radiograph. The perforation site was sealed with MTA, followed by Metapex obturation. Follow-up visits at 90 days showed clinical and radiographic success of treatment. Conclusion: Therefore, MTA may be considered an alternative option for the repair of furcal perforation in primary teeth, prolonging the longevity of these dental elements.

  1. Pace R, Giuliani V, Pagavino G. Mineral trioxide aggregate as repair material for furcal perforation: Case series. J Endod 2008;34(9): 1130–1133. DOI: 10.1016/j.joen.2008.05.019.
  2. American Association of Endodontists, (Ed). Glossary of endodontic terms, 10th edition. Chicago: American Association of Endodontists, 2020.
  3. Aldayri B, Nourallah AW, Badr F. Clinical and radiographic evaluation of the healing after MTA application on mechanical furcal perforations in primary Molars-part 2. Preprints 2019:2019050322. DOI: 10.20944/preprints201905.0322.v2.
  4. Azim AA, Lloyd A, Huang GT. Management of longstanding furcation perforation using a novel approach. J Endod 2014;40(8):1255–1259. DOI: 10.1016/j.joen.2013.12.013.
  5. Akhavan PS, Afsharianzadeh M, Asnaashari E. Repair of primary molar root perforation with MTA: A case report. Journal of Islamic Dental Association of IRAN (JIDAI) 2014;25(4):4. Available from:
  6. Agarwal S, Parvez S, Agarwal M, Khatri R, Mehak. Combination of MTA and PRF for the management of iatrogenic pulpal floor perforation with grade II furcation involvement: Case report. IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) 2020;19(12):35–39. DOI: 10.9790/0853-1912043539.
  7. Rudagi KB, Rudagi BM. One-step apexification in immature tooth using grey mineral trioxide aggregate as an apical barrier and autologous platelet rich fibrin membrane as an internal matrix. J Conserv Dent 2012;15(2):196–199. DOI: 10.4103/0972-0707.94582.
  8. Araújo RA, Silveira CF, Cunha RS, De Martin AS, Fontana CE, Bueno CE. Singlesession use of mineral trioxide aggregate as an apical barrier in a case of external root resorption. J Oral Sci 2010;52(2):325–328. DOI: 10.2334/josnusd.52.325.
  9. Steinig TH, Regan JD, Gutmann JL. The use and predictable placement of mineral trioxide aggregate in one-visit apexification cases. Aust Endod J 2003;29(1):34–42. DOI: 10.1111/j.1747-4477.2003.tb00496.x.
  10. Simon S, Rilliard F, Berdal A, Machtou P. The use of mineral trioxide aggregate in onevisit apexification treatment: A prospective study. Int Endod J 2007;40(3):186–197. DOI: 10.1111/j.1365-2591.2007.01214.x.
  11. Mishra N, Narang I, Iqbal MJ, Singh P, Singh N, Pranab A. Apexification of the mineral trioxide aggregate in nonvital immature anterior teeth with and without platelet-rich plasma: A preliminary clinical study. The Saint's International Dental Journal 2023;7(1):20–26. DOI: 10.4103/sidj.sidj_7_23.
  12. Oliveira TM, Sakai VT, Silva TC, Santos CF, Machado MA, Abdo RC. Repair of furcal perforation treated with mineral trioxide aggregate in a primary molar tooth: 20-month follow-up. J Dent Child 2008;75(2):188191. PMID: 18647517.
  13. Rodd HD, Waterhouse PJ, Fucks AB, Fayle SA, Moffat MA. UK national clinical guidelines in pediatric dentistry (Pulp therapy for primary molars). Intern J Pediat Dent 2006;16(1):15–23.
  14. Holland R, Bisco Ferreira I, de Souza V, Otoboni Filho JA, Murata SS, Dezan E Jr. Reaction of the lateral periodontium of dogs’ teeth to contaminated and noncontaminated perforations filled with mineral trioxide aggregate. J Endod 2007;33(10):1192–1197. DOI: 10.1016/j.joen.2007.07.013.
  15. Al- Dafaas A, Al- Nazhan S. Healing evaluation of contaminated furcal perforation in dogs’ teeth repaired by MTA with and without internal matrix. Oral Surg Oral Med Oral Pathol Oral Endod 2007;103(3): e92–e99. DOI: 10.1016/j.tripleo.2006.09.007.
  16. Parirokh M, Torabinejad M. Mineral trioxide aggregate: A comprehensive literature review- Part III: Clin applications, drawbacks, and mechanism of action. J Endod 2010;36(3):400–413. DOI: 10.1016/j.joen.2009.09.009.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.