The Effect of different treatment modalities on healing of furcation perforation in dogs teeth

Abstract

The aim of the present study was to compare radiographically and histopathologically the effect of MTA, PRP and PRF on healing of non-contaminated and contaminated furcation perforation. Twelve healthy adult mongrel dogs with no evidence of periodontal disease, weighing 15-25 kg and approximately 1 year old were selected. A total number of the teeth (192) was divided into three groups according to the post treatment evaluation periods; group I, II and III for evaluation periods of one week, one month and three months respectively each of 64 teeth. Each group was further subdivided according to treatment modality into subgroup (A) Mineral trioxide aggregate “MTA” ( 16 teeth), subgroup (B) Platelet Rich Plasma “PRP” ( 16 teeth), subgroup (C) Platelet Rich Fibrin “PRF” ( 16 teeth), subgroup (D) negative control ( 8 teeth) and subgroup (E) positive control ( 8 teeth). Subgroup A, B and C were further subdivided according to perforation status into subdivision 1 (non-contaminated) and subdivision 2 (contaminated) each of 8 teeth. Access opening, pulp extirpation, instrumentation and root canal obturation were done for teeth in subgroup A, B, C and E while subgroup D (negative control) left untouched. Perforation was created in contaminated samples and left open for 4 weeks. In non-contaminated samples access opening was sealed with temporary filling for 4 weeks. After 4 weeks the access opening and perforation canal were cleaned and irrigated in contaminated samples, while in non-contaminated samples the temporary seal was removed and perforation was created at that time. Summary and Conclusions 153 Radiographic evaluation included measuring the percent of change in vertical bone loss at furcation perforation. Histologic evaluation included inflammatory cell count, cemental deposition, new bone formation, bone resorption and epithelial proliferation. Data were collected, tabulated and statistically analyzed. Results Regarding vertical bone loss, no change in vertical bone loss was demonstrated after one week (group I). In group II (one month) and III (three months), no statistical significant difference in vertical bone loss among non-contaminated samples of experimental subgroups MTA, PRP and PRF. While, in contaminated samples, significant difference in vertical bone loss was found between subgroup A “MTA” and both subgroup B “PRP” and C “PRF” with no significant deference between subgroup B “PRP” and C “PRF”. Regarding evaluation period, in non-contaminated samples there was significant change from one week to one month, but without significant change in vertical bone loss from one month to three months. While in contaminated samples the vertical bone loss was significantly changed from one week to one month and from one month to three months. Regarding inflammatory cell count, in group I (one week) and II (one month), subgroup A demonstrated statistically higher inflammatory cell count than subgroup B and C. However, no significant difference in inflammatory cell count was found between subgroup B and C, in non-contaminated and contaminated samples. In group III (three months), non-contaminated samples showed that there was significant difference between all experimental Summary and Conclusions 154 subgroups, while in contaminated samples statistical analysis was similar to that in group 1 and II. The inflammatory cell count was significantly reduced in all experimental subgroups with time, either contaminated or non-contaminated. As regard to perforation status, there was significant difference between non-contaminated and contaminated samples within each subgroup. Regarding cemental deposition, in group I, II and III, there was no significant difference between all experimental subgroups. As regard to evaluation periods, significant increase in mean of cemental deposition score was demonstrated from one week to one month. However, no significant increase in mean of cemental deposition from one month to three months. Non-contaminated samples demonstrated significant increase in mean of cemental deposition from that in contaminated samples with in each subgroup. Regarding new bone formation, in group I, II and III, no statistical significant difference was found between all experimental subgroups. Subgroups with non-contaminated samples demonstrated significant increase in mean score of bone formation from one week to one month and from one month to three months. While subgroups with contaminated samples showed significant increase in mean score of new bone formation from one week to one month, while from one month to three months no significant difference was demonstrated. Non-contaminated samples demonstrated significant increase in mean score of new bone formation from that in contaminated samples with in each subgroup. As regard to bone resorption, in group I, II and III there was no significant difference