An interdisciplinary approach for management of an Endo-Perio Lesion in a necrotic Mandibular Second Molar with a type I Furcation Canal: A Case Report with a 6-month Follow-up | ||
| Advanced Dental Journal | ||
| Volume 7, Issue 4, October 2025, Pages 595-601 PDF (520.63 K) | ||
| Document Type: Case Reports | ||
| DOI: 10.21608/adjc.2024.291504.1558 | ||
| Author | ||
| Ahmed Eltokhy* | ||
| Department of Endodontics, Cairo University, Cairo, Egypt | ||
| Abstract | ||
| Introduction: Communications between endodontic and periodontal tissue may occur through apical foramen and lateral canals allowing bi-directional spread. Furcation canals are considered-lateral canals found at the floor of the pulp chamber. Infected pulps may induce tissue destruction-in adjoining periodontal tissues, apically and in the bifurcation area. Proper root canal shaping, disinfection as well as Furcation canals’ identification and management are a true challenge. Case Report: A 41-year-old male complaining from pain in mandibular left second molar, Clinical and radiographic examinations revealed that there was a large carious lesion and bifurcation and peri-radicular bone resorption with a pocket draining pus. The mandibular left second molar was diagnosed to have a necrotic pulp and symptomatic apical-periodontitis with secondary periodontal-lesion involving large intra-radicular bone resorption. Scaling and root planning were done. Using a dental operating microscope identified a furcation canal upon access cavity; Canals were prepared-and filled with CaOH. On the second visit NaOCl Irrigation was activated and canals were obturated by utilizing a bio-ceramic sealer. The furcation canal was sealed with Well-Root bio-ceramic Putty. After 10-week follow-up the patient was asymptomatic. Radiographic examination revealed bone-deposition in inter-radicular region. At 6 months the tooth was pain-free and functioning. Conclusion: An interdisciplinary approach to treat endo-perio lesions is mandatory to ensure-favorable outcomes. The presence of furcation canals has a notable impact on the prognosis of endodontic treatments. Proper root canal shaping, disinfection as well as identification of Furcation-canals and their effective sealing are crucial steps in management of infection of endodontic origin-and ensuring treatment success. | ||
| Keywords | ||
| furcation canals; endo-perio lesion; apical periodontitis; bio-ceramic putty | ||
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