Nugraeni, Yuli and Prahasanti, Chiquita (2010) Multidisciplinary management of a mandibular buccal plate perforation. Dental Journal, 43 (4). pp. 195-200. ISSN 1978-3728

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Abstract

Background: Endodontists often have difficulty in the management of endo-perio cases, because they cannot visually detect the condition of outer root surfaces, especially in bucco-lateral roots. The bone defect is rare and its treatment needs collaboration of endodontists and periodontists. An endodontist treats cases based on dental history, radiograph of root canals to measure root canals, to uncover abnormalities and to diagnose, but as the endodontists cannot directly see the affected parts, the unseen portion of the tooth could only be seen after flap surgery. Purpose: This case presents the importance of multidisciplinary approach by the endodontist and periodontitis to treat bucal plate perforations in endo-perio cases. Case: The first patient, a 47-year-old female had endodontic treatment and a porcelain crown restoration; however, after several months she felt pain. The second patient, a 45 year-old female had endodontic treatment and after six months she feel painful. Case management: The first patient, was referred to a periodontist. The opening flap surgery has been done, a bone defect was found in tooth 45. Subsequently, the exposed crater was filled with a bone graft and the pain disappeared. The second patient, with improper endodontic treatment. The flap surgery was conducted, there was found a bone defect in tooth 36. The last treatment, a bone graft has been covered and then the pain was not present. Conclusion: Proper diagnosis and treatment of perforations on the buccal aspect of a root was able to eliminate pain and avoid tooth extraction. Key words: Bucco-lateral defect, endo-perio lesion, management

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