Furcation Perforation — ORE Part 1 MCQ

Instant feedback + full explanation. One question, done properly.

HardEndodonticsFurcation PerforationORE Part 1

A patient undergoing root canal retreatment of a lower molar develops a sudden perforation of the furcation floor. Fresh blood is seen in the pulp chamber. What is the most appropriate immediate management?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: E — Seal the perforation with MTA or Biodentine immediately

Immediate sealing of furcation perforations with biocompatible bioactive materials (MTA or Biodentine) is the established standard of care supported by current endodontic evidence. The presence of fresh blood indicates the perforation was recent and vital tissues are exposed—this mandates prompt action to prevent bacterial contamination and inflammatory progression into the furcation space. Immediate sealing minimises periradicular bone loss and optimises healing outcomes. Option C (calcium hydroxide) uses an outdated material with poor long-term sealing ability and delays definitive repair. Option D (extraction) is reserved for irreparable cases with extensive damage or failed conservative repair. Option B (surgical repair) is an alternative when non-surgical sealing is not feasible, but immediate non-surgical sealing should be attempted first. Option A (stainless steel post) is not a recognised management approach and would not seal the periodontal defect effectively.

Reference: Saad Al-Nazhan et al., Outcomes of furcal perforation management using Mineral Trioxide Aggregate and Biodentine: a systematic review, Journal of Applied Oral Science, 2022. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9724492/