الفهرس 
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Abstract
The aim of this study was to compare between MTA and Biodentine repairing materials regarding new hard tissue formation after repair of the perforation site. The study included radiographic, histological and immunohistochemical analysis for evaluation of the treatment outcomes over three months’ evaluation period. The total of 96 teeth from 6 healthy adult dogs were selected.
The selected dogs were of both sexes and clinically normal. All teeth were intact, free from caries and had complete root development. The animals will be divided into two main experimental groups of 46 teeth, three dogs each (96 teeth) according to the time of repair. Each main group will be divided into three subgroups of 16 teeth each according to the evaluation periods of 1, 2, and 3 months. Each subgroup will be further subdivided into four subgroups according to the material used.
After anesthesia, the teeth were instrumented and obturated. In experimental and positive control samples, the teeth were perforated in the center of the pulp chamber floor. The access cavities of the GI samples were immediately sealed, while the access cavities of GII was left open for saliva contamination for 1 month. Each dog was reanaesthesized and radiographs were taken to confirm the formation of furcal lesions (preoperative radiographs). Then the perforation sites were curated to remove debris and inflamed tissues cleaned with saline and dried. According to the time of repair, two different materials were used; Subgroup A was sealed with MTA and subgroup B was sealed with Biodentine. Then the animals were returned to the animal house in Surgery, Anesthesiology and Radiology department, Cairo university and left for follow up according to the post treatment evaluation periods. In the end of each evaluation period, the animal was reanaesthesized and the radiographs were exposed as follow up radiographs (postoperative radiographs). In this study, the data were evaluated radiographically and histologically.
Radiographic evaluation: periapical preoperative radiograph after perforation repair compared with follow up radiographs according to post treatment evaluation periods using Image J analysis software and Turbo-Reg plug in. Bone loss was measured in each subgroup, data were collected and statistically analyzed. Histologic evaluation: Blocks were decalcified, sectioned and examined under microscope, Inflammatory tissue reaction (inflammatory cell count) was evaluated. Immunohistochemical analysis was performed using osteonectin antibodies for assessment of new hard tissue formation.
Then all data obtained were subjected to statistical analysis.
Results: Radiographic evaluation showed no significant difference between MTA, Biodentine and positive control in one-month period. Significant difference was seen at two-month and three-month time periods where radiolucency size decreased in MTA and Biodentine while increased in positive control.
Histologic evaluation was done to assess inflammatory cell count showed that; At one-month period, there was no statistical significant difference between MTA, Biodentine and positive control, all showed highest inflammatory cell count. Significant difference was found at two-month and three-month time periods where the cell counts were decreased in MTA and Biodentine while increased in positive control.
Immunohistochemical analysis was performed to assess new hard tissue formation showed that; At one-month period, there was a slight tissue deposition in few samples and the healing was not clear at this time period. At two-month and three-month evaluation periods, the evidence of hard tissue was noticed with no significant difference between MTA and Biodentine, both found with highest deposition of hard tissue and furcation repair. Positive control was significantly lower regarding hard tissue deposition, as there was no new hard tissue formation.
Conclusions:
1- Furcation perforation has poor prognosis if the perforation site is not immediately repaired
2- Both tested materials; MTA and Biodentine are excellent materials for furcation repair
3- Healing process of bone in furcation perforations needs long periods of time.
Recommendations:
1- Longer follow up period is needed to evaluate the healing of furcation perforation.
2- More investigations on immunological and cellular components of furcation perforation repair are needed.