Perfuração de furca: tratamento por meio de materiais biocerâmicos - relato de caso

Abstract

Perforations account for 10% of cases of endodontic treatment failure. These occur when there is communication between the root canal system and the external surface of the tooth, which may result from pathological processes or iatrogenic procedures. The recovery of the dental element through the application of sealing materials, such as bioceramics, would significantly minimize the secondary effects of furcation lesions, providing a better prognosis for the treatment. Thus, the objective of this study is to report a clinical case of perforation in the furcation region of a lower first molar, treated with a bioceramic material, describing the advantages and benefits of this method as an alternative to restoring the success of endodontic treatment. A male patient attended the School of Dentistry at the Federal University of Juiz de Fora, complaining of painful symptoms during chewing, referring to tooth #36. Thermal sensitivity tests (hot and cold) were performed, both yielding positive responses. Based on clinical and radiographic examinations, a diagnosis of symptomatic irreversible pulpitis was established. During the endodontic treatment, when accessing and locating the canals, intense bleeding raised suspicion of a furcation perforation, which was confirmed by imaging exams and the aid of an electronic apex locator. As a protocol for sealing the perforation, the cavity was irrigated with calcium hydroxide solution, followed by the application of intracanal medication (calcium hydroxide paste) and Calcium Hydroxide P.A over the perforation. After one week, the root canals were obturated, and CIMMO HD® bioceramic was applied over the perforation. The region was protected with a chemically activated glass ionomer cement liner, followed by a definitive restoration. After one year, the tooth showed no signs or symptoms of treatment failure. Thus, based on the clinical application of CIMMO HD®, it was concluded that its use in repairing furcation lesions proved to be effective, ensuring a successful endodontic treatment.