الفهرس 
REVIEW OF LITERATUREOnly 14 pages are availabe for public view
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Abstract
The aim of the present study was to compare between MTA, Biodentine, and Experimental tricalcium silicate bone cement regarding bone loss, inflammatory tissue reaction and new hard tissue formation after repair of the furcal perforation defect. This study included radiographic, histological, and immunohistochemical analysis; for evaluating the treatment outcomes over 3month evaluation period.
A total of 162 teeth from 12 healthy adult dogs were selected. All teeth were intact, and had complete root development. The dogs were divided into three main experimental groups of 54 teeth, 4 dogs each, according to the evaluation period. Each group was further divided into two equal Subgroups of 27 teeth, 2dogs each, according to the time of repair. Each of these two Subgroups was further subdivided into five subdivisions according to the material used; MTA, Biodentine, Experimental material, positive control and negative control.
After anesthetizing the dogs, the teeth were cleaned, shaped and obturated. Perforations were created in the center of the maximum curve of the pulp chamber floors. The perforations in Subgroup (A) were sealed immediately while; the perforations were left open for 1month for salivary contamination in Subgroup (B). No perforations were made in the negative control group (Subdivision 5) while the perforations were left open without repair in the positive control group (Subdivision 4). The three study materials used were; MTA (Subdivision 1), Biodentine (Subdivision 2), and Experimental tricalcium silicate cement (Subdivision 3). Then the animals were returned to the animal house in; Surgery, Anesthesiology and Radiology department, Cairo University, and were left for follow up according to the post treatment evaluation period; 1month (GI), 2month (GII), and 3month (GIII). At the end of each evaluation period, the dogs were reanaesthesized and postoperative radiographs were taken.
Radiographic evaluation compared between the preoperative and postoperative radiographs assessing bone loss using Image J analysis. Histological evaluation of the inflammatory cell count was carried out after preparing the samples for H&E stain for microscopic examination. Furthermore immunohistochemical analysis was carried out through the Osteopontin+ve area fraction to assess hard tissue formation. All data were collected, tabulated and statistically analyzed.
Results of the radiographic evaluation showed that; there was a statistically significant difference between the three evaluation periods (GI: 1month, GII: 2month, and GIII: 3months) assessed when MTA, Biodentine and Experimental material were used to seal contaminated furcal perforations where the highest bone loss was recorded in the 3months evaluation period (GIII) in all samples. However, there was no statistically significant difference between the three evaluation periods assessed when MTA and Biodentine were used to immediately seal the furcal perforations. Highest bone loss was recorded in the positive control group (Subdivision 4), where there was a statistically significant difference between the three evaluation periods, with the highest bone loss in the 3month evaluation period (GIII). Moreover, there was a statistically significant difference between immediately repaired furcal perforations and contaminated perforations that were repaired after 1month (GI), with the highest bone loss in the delayed repair group (Subgroup B). Nevertheless there was a statistically significant difference between the three study materials when used to repair contaminated perforations in Subgroup B, whereas there was no statistically significant difference between the three study materials when used to immediately repair furcal perforations in Subgroup A. Results of the histological evaluation showed that there was a statistically significant difference between the three evaluation periods when the three study materials were used to repair furcal perforations whether immediate or delayed repair, with the lowest inflammatory cell counts recorded in the 3month period (GIII). There was a statistically significant difference between the immediate repair (Subgroup A) and delayed repair group (Subgroup B). Moreover there was a statistically significant difference between the three study materials (Subdivision: 1, 2, and 3) when used to immediately repair perforations (Subgroup A), with the lowest inflammatory cell count recorded in the Experimental material (Subdivision 3). While there was no statistically significant difference between; the three study materials in the delayed repair group (Subgroup B). Finally the immunohistochemical analysis revealed a statistically significant difference between the three evaluation periods (GI, GII, and GIII) when any of the three materials was used to repair perforations, with the highest immunopositive area fraction in the 3month evaluation period (GIII). Nevertheless there was no statistically significant difference between the three study materials when used to repair furcal perforations, with the highest immunopositive area fraction in the Experimental material (Subdivision 3).
Conclusion:
1- The three tested materials; MTA, Biodentine, and Experimental material provided favorable conditions for periodontal tissue repair following perforation. They were capable of causing regeneration of the adjacent periodontium and hence could be used in furcal perforation repairs
2- Experimental tricalcium silicate bone cement showed promising results comparable to Biodentine and MTA.
3- Delayed furcal perforation repair presented worse prognosis than the immediately repaired furcal perforations.
4- The three materials used in the current study were comparable regarding the Osteopontin expression.
5- Healing potentiality increased as the evaluation period increased.
Recommendations:
1-Further investigations on immunological and cellular components are recommended to assess tricalcium silicate bone cement manufactured through sol-gel synthesis.
2- Longer follow up period is needed to evaluate the furcal perforation healing.