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Perforation – Ep. 42

Guest: Kreena Patel, BDS(Hons), MJDF RCS(Eng), MClinDent (Endodontology), MEndo RCS(Edin)

In this episode of Endo Voices we dig deep highlighting an important topic no one wants to experience iatrogenically, but which is nevertheless a well-known uncommon risk of treatment: perforations. Perforations and the implications of how practitioners tackle this scenario are paramount. We review this topic with international endodontist extraordinaire Dr. Kreena Patel from London. She aims to restore any voids in listeners’ knowledge with updates on the latest perforation protocols, techniques and materials. She seamlessly weaves in the importance of leveraging technology when developing a diagnosis, as well as differentiates between a bleeding spot from perforation vs. bleeding from an accessory canal. Listen in as we cover the “file flutter” phenomenon and the most critical elements of perforation recognition and location, and how these influence prognosis.  Dr. Patel also wows us with her academic and literature prowess and succinctly breaks down optimal uses, properties and setting times of various materials like tricalcium silicates and MTA.

Episodes of Endo Voices may include opinion, speculation and other statements not verifiable in the scientific method and do not necessarily reflect the views of AAE or the sponsor(s). Listeners should use their best judgment in evaluating the merits of any content.

Episode Resources

  1. Gutman JL. The “roots” of the ideal filling material. J hist Dent. 2001; 49.
  2. Silva E, Canabarro A, Andrade M et al. Dislodgement resistance of bioceramic and epoxy sealers: a systematic review and meta-analysis. J Evid Based Dent Pract. 2019; 19(3): 221-235.
  3. Park MG , Kim IR, Kim HJ, Kwak SW, Kim HC. Physicochemical properties and cytocompatibility of newly developed calcium silicate-based sealers. Aust Endod J. 2021; 47(3): 512-519
  4. Camps J, Jeanneau C, El Ayachi I, Laurent P, About I. Bioactivity of a calcium silicate-based endodontic cement (BioRoot RCS): interactions with human periodontal ligament stem cells in vitro. J Endod. 2015; 41(9): 1469-1473


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