130 Marmara Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi Cilt: 2, Sayı: 3, 2012 / Journal of Marmara University Institute of Health Sciences Volume: 2, Number: 3, 2012 - http://musbed.marmara.edu.tr Treatment of a Complicated Iatrogenic Furcation Perforation in a Mandibular Molar with Bicuspidization Technique: A Case Report Taner Arabaci 1 , Yasin Çiçek 1 , Hasan Güngör 2 1 Department of Periodontology, Atatürk University, Faculty of Dentistry, Erzurum - Turkey 2 Department of Prosthodontics, Atatürk University, Faculty of Dentistry, Erzurum - Turkey Yazışma Adresi / Address reprint requests to: Dr. Taner Arabacı Atatürk Üniversitesi, Diş Hekimliği Fakültesi, Periodontoloji Anabilim Dalı, 25240, Erzurum, Turkey Elektronik posta adresi / E-mail address: t-arabaci@hotmail.com Kabul tarihi / Date of acceptance: 12 Temmuz 2012 / July 12, 2012 ÖZET Alt çene büyük azı dişinde komplike bir iatroje- nik furkasyon perforasyonunun biküspidizasyon tekniği ile tedavisi: vaka raporu İatrojenik furkasyon perforasyonu, endodontik tedavi esnasında dişin prognozunu oldukça azaltan önemli hatalardan biridir. Günümüzde, çoğu pratisyen hekim kompleks tedavi prosedürlerinden kaçınmak için bu gibi perfore dişlerin çekimini ve bunun yerine sabit protez ya da dental implantların yerleştirilmesini tercih etmektedir. Bunlar farklı birer tedavi alternatifi olarak düşünülse de, bu gibi etkilenmiş dişlerin çekim yerine tedavi edilmeleri gelişmekte olan diş hekimli- ğinin birinci amacı olmalıdır. Bu vaka raporunda, endodontik hataya bağlı alt çene büyük azı dişinde gelişen komplike bir furkasyon perfo- rasyonunun biküspidizasyon tekniği ile tedavisi ve sonraki dönemde çevreleyen periodontal dokuların iyileşmesi sunulmaktadır. Anahtar sözcükler: Furkasyon, perforasyon, biküspidizasyon ABSTRACT Treatment of a complicated iatrogenic furcation perforation in a mandibular molar with bicuspidization technique: a case report Iatrogenic furcation perforation is one of the important failures during endodontic treatment and significantly reduces the tooth prognosis. Today, many of the practitioners prefer extracting the involved tooth and replacing it with fixed prostheses or dental implants to avoid the complexity of the treatment procedures. Although these may be thought as other treatment alternatives, treating instead of extracting the involved teeth must be the primary scope of developing dentistry. This case report presents the treatment of a complicated mandibular molar furcation perforation depending on endodontic failure with bicuspidization technique, and subsequent healing of the surrounding periodontium. Key words: Furcation, perforation, bicuspidization MÜSBED 2012;2(3):130-133 Olgu Sunumu / Case Report INTRODUCTION Iatrogenic furcation perforations can occur during root canal treatment or preparing a canal for a post (1,2). Furcal- floor may also be perforated accidentally when seeking the root canal entrances (3). Perforations of the furcal-floor mostly cause inflammation in the furcation region and reduce the prognosis of the involved tooth (2). If the furcation region is not invaded with any filling or root sealant material, the perforation may be repaired using a hermetic and biocompatible sealant (4). However, if the furcation region is also irritated with root sealant or other filling materials, surgical access will be required in order to remove the irritants under the fornix. Furcations are the limited regions for adequate access and for removing the irritants from the area with non- surgical procedures (5). Therefore, the preferred treatment procedure is often the surgical flap operation (6). Resective surgery procedures such as root amputation, hemisection, bisection/bicuspidization (bisectioning) and radisection techniques are the various surgical treatment alternatives of furcation involvements, and attempt the excision and removal of any segment of the tooth or a root with or without its crown portion (7). Bisection/bicuspidization technique is the separation of mesial and distal roots of mandibular molars along with its crown portion, where both segments are then retained individually (8). It is usually performed in Grade II or III furcation defects of mandibular molars, and preferred to remove the irritants under the fornix and to obtain two single-rooted teeth for crowning as premolar (9).