Successful Application of Atelocollagen for Treatment of Perforated Teeth

Objective: Cervical or furcal root perforation is a serious clinical problem and one of its treatment modalities is perforation repair with composite resin. However, many cases still progress in inevitable extraction. When primary teeth are affected, early tooth loss can cause problems related to the eruption space for the permanent successors. The aim of the present study was to evaluate a novel clinical treatment method for perforated teeth. Study design: Atelocollagen was applied to perforated furcal and cervical areas of 13 primary teeth in 13 children aged 4-9 years and 8 permanent teeth in 8 adults aged 35-69 years after debridement with an electric knife. Thereafter, the final restorations were performed after confirming good tooth conditions. Clinical evaluations were performed at follow-up examinations at approximately 3-month intervals.Results: None of the treated primary teeth showed any clinical problems throughout the observation period, with eruption of the permanent successors noted in 7 cases. In the permanent teeth, no clinical problems were identified in any of the cases during follow-up periods of 10-60 months. Conclusion: This novel method may enable preservation of perforated primary teeth for a longer duration.

perforated teeth, furcation, primary teeth, permanent teeth, atelocollagen

1. Zadik Y, Sandler V, Bechor R, Salehrabi R. Analysis of factors related to extraction of endodontically treated teeth. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 106: e31–e35, 2008. 

2. Sluyk SR, Moon PC, Hartwell GR. Evaluation of setting properties and retention characteristics of mineral trioxide aggregate when used as a furcation perforation repair material. J Endod, 24: 768–771, 1998.

3. Breault  LG,  Fowler  EB,  Primack  PD.  Endodontic  perforation  repair with  resin-ionomer:  a  case  report.  J  Contemp  Dent  Pract,  1:  48–59, 2000.

4. Hsien HC, Cheng YA, Lee YL, Lan WH, Lin CP. Repair of perforating internal  resorption  with  mineral  trioxide  aggregate:  a  case  report. J Endod, 29: 538–539, 2003.

5. Cuoghi OA, Bertoz FA, de Mendonca MR, Santos EC. Loss of space and dental arch length after the loss of the lower first primary molar: a longitudinal study. J Clin Pediatr Dent, 22: 117–120, 1998.

6. Oliveira TM, Sakai VT, Silva TC, Santos CF, Machado MA, Abdo RC. Repair of furcal perforation treated with mineral trioxide aggregate in a primary molar tooth: 20-month follow-up. J Dent Child, 75: 188–191, 2008.

7. Sano A, Maeda M, Nagahara S, Ochiya T, Honma K, Itoh H, Miyata T, Fujioka  K.  Atelocollagen  for  protein  and  gene  delivery.  Adv  Drug Deliv Rev, 55: 1651–1677, 2003. 

8. Lynn AK, Yannas IV, Bonfield W. Antigenicity and immunogenicity of collagen. J Biomed Mater Res B Appl Biomater, 71: 343–354, 2004. 

9. Omura S, Mizuki N, Horimoto S, Kawabe R, Fujita K. A newly devel-oped  collagen/silicone  bilayer  membrane  as  a  mucosal  substitute:  a preliminary report. Br J Oral Maxillofac Surg, 35: 85–91, 1997. 

10. Matsui  R,  Osaki  K,  Konishi  J,  Ikegami  K,  Koide  M.  Evaluation  of an  artificial  dermis  full-thickness  skin  defect  model  in  the  rat.  Biomaterials, 17: 989–994, 1996.

11. Matsui  R,  Okura  N,  Osaki  K,  Konishi  J,  Ikegami  K,  Koide  M.  Histological evaluation of skin reconstruction using artificial dermis.  Biomaterials, 17: 995–1000, 1996. 

12. Takenaka Y, Iijima M, Kawano S, Akita Y, Yoshida T, Doi Y, Sekine I. Fabrication of fine apatite/collagen composite for osteoconductive api-cal barrier material. J Ceram Soc Jpn, 116: 92–95, 2008.