Camilo do Carmo Monteiro Jardel, Rodrigues Tonetto Mateus, Coêlho Bandeca Matheus, Henrique Borges Alvaro, Cláudio Martins Segalla José, Cristina Fagundes Jordão-Basso Keren, Fernando Sanchez-Puetate Cristian, Carlos Kuga Milton
Department of Restorative Dentistry, Araraquara School of Dentistry, Univ Estadual Paulista, Araraquara, SP, Brazil.
Department of Postgraduate Program in Integrated Dental Science, University of Cuiaba-UNIC, Cuiabá, MT, Brazil.
Iran Endod J. 2017 Fall;12(4):516-520. doi: 10.22037/iej.v12i4.16888.
Teeth with furcal perforation present difficult resolution and dubious prognosis. Several materials have been proposed and calcium silicate-based cements such as mineral trioxide aggregate (MTA) are the most recommended. However, its long-term clinical behavior still remains poorly understood. The present study reports a clinical case of furcal perforation repair using Angelus MTA, with a 7-year follow-up. Patient sought treatment 2 months after iatrogenic accident. First lower right molar presented clinical signs such as fistula and bone loss between mesial and distal roots. Firstly, all root canals were treated and then furcal perforation was sealed with MTA Angelus and the dental crown was restored with composite resin. Radiographic evaluation was immediately performed to analyze the furcal perforation filling. After 7 years, a new clinical and imaging evaluation using periapical radiography and cone-beam computed tomography (CBCT) showed absence of clinical signs and symptoms, and alveolar bone reconstitution with periodontal space reduction. Angelus MTA presented good clinical behavior in the iatrogenic furcal perforation resolution based on long-term clinical evidence.
存在根分叉穿孔的牙齿治疗难度大且预后不明。已有多种材料被提出，而诸如矿物三氧化物凝聚体（MTA）等硅酸钙基水门汀是最常被推荐的。然而，其长期临床表现仍知之甚少。本研究报告了一例使用安吉利斯MTA修复根分叉穿孔的临床病例，并进行了7年的随访。患者在医源性事故发生2个月后寻求治疗。右下第一磨牙出现了诸如瘘管以及近中根与远中根之间骨质丧失等临床症状。首先，对所有根管进行了治疗，然后用安吉利斯MTA封闭根分叉穿孔，并用复合树脂修复牙冠。立即进行了影像学评估以分析根分叉穿孔的充填情况。7年后，使用根尖片和锥形束计算机断层扫描（CBCT）进行的新的临床和影像学评估显示，没有临床症状和体征，并且牙槽骨重建，牙周间隙减小。基于长期临床证据，安吉利斯MTA在医源性根分叉穿孔的治疗中表现出良好的临床效果。
