Nonsurgical Management of Furcation Defects Using Cervical Sealing With Calcium-Silicate Cements: A Clinical Case Series.

Abstract

Furcation defects pose significant challenges in endodontic and periodontal therapy due to their complex anatomy and limited accessibility. Achieving a reliable seal at the apical/cervical/coronal levels is critical for long-term treatment success. This case series investigates the use of calcium-silicate biomaterials, specifically calcium-enriched mixture (CEM) cement, as cervical sealants in the nonsurgical management of furcation defects with endodontic origin, evaluating their regenerative potential and clinical applicability. Six endodontically treated teeth with furcation defects were included. All cases had undergone orthograde root canal therapy in the past and then were nonsurgically retreated with CEM cement placed as a cervical seal for this report. Baseline and follow-up evaluations, conducted over an average period of 31 months, assessed the clinical parameters of probing depths, furcation involvement, and radiographic evidence of healing. Radiographically, five cases demonstrated complete healing/regeneration, and one case showed partial resolution of the furcal lesion. Improvements in periodontal parameters, including lesser probing depths and elimination of bleeding and discharge, were observed across all cases, resulting in restored functionality of the affected teeth. The results suggest that CEM cement was an effective cervical sealing biomaterial for the nonsurgical management of furcation defects with endodontic origin. These findings highlight the potential of bioactive endodontic materials in minimally invasive dental therapies. Further studies with larger sample sizes and long-term follow-ups are needed to validate these findings.