Evaluation of healing with use of an internal matrix to repair furcation perforations.

By Rafter M, Baker M, Alves M, Daniel J, Remeikis N

Date: 08/2002
Journal: JOE

Summary:  

Purpose:  to evaluate healing responses following repair of furcation perforations, with and without an internal matrix. Two matrix materials, HAPSET (65% non-resorbable hydroxyapatite and 35% plaster of paris) and hydroxyapatite were compared.

N= 80 teeth in 20 Monkey  (molar & premolar)

Materials/Methods: 

•Furcation perforations were made then the teeth were randomly assigned to one of 5 groups. (Table 1)

•Following repair of the perforation, the floor of the pulp chamber was sealed with heat-softened GP and the occlusal access cavity was restored with amalgam.

•The animals were scarified 1 week, 1 month, 3 months and 7 months after the procedures.

•The tissues were sectioned longitudinally in a M-D plane until the defect is reached.

•Each section was evaluated for (1)Epithelial reaction (2)Inflammation (3)Connective tissue reaction (4) Bony reaction

Most highlighted Results:   üWhen amalgam was used alone without a matrix, there was marked extrusion of the material with severe inflammatory response, which continued throughout the observational period üRadiographs à periodontal break- down in the furcation region in the unsealed group & the amalgam group while Furcation RL were not observed in either matrix groups. ü1week à (moderate to severe) acute inflammatory reaction in the furcal bone in all perforated specimens. ü1 month à fibrous encapsulation of both matrix materials was observed à in later time periods, there was evidence of new bone formation in direct contact with the matrix materials. üThere was no apparent difference in the CT and bone response to HAPSET or hydroxyapatite.

Clinical significance:

placement of an internal matrix results in superior healing of furcation perforations, when compared with use of amalgam without such a matrix.