The purpose of treating furcal perforation is to seal the artificial communication between the canal space and the periradicular tissue to prevent the periodontal breakdown. The duration, size and location of the perforation were identified as the primary prognostic factors for determining successful treatment. Mineral trioxide aggregate (MTA) has been regarded as an ideal material for perforation repair owing to its excellent sealability and biocompatibility. The present case report illustrates the efficiency of MTA in the delayed treatment of a large iatrogenic furcation perforation of the right mandibular second molar tooth with a duration of 8 weeks from perforation occurrence to repair. The tooth received a two-visit non-surgical root canal treatment prior to perforation repair using MTA without internal matrix. The healing of periradicular radiolucent lesions and interradicular radiolucency at 18 months indicated the successful sealing of the perforation. The outcome also indicated that MTA was able to seal the furcation perforation effectively in a large defect with delayed treatment time.

Structurally compromised teeth tend to be extracted due to its their poor prognosis, however, hemisection may serve as an alternative option in selected cases. This case report is aimed to discuss two cases of hemisected mandibular molars with two different approaches for post-hemisection restoration. Case 1 presents with terminal tooth 37 diagnosed with a cracked tooth involving severe bone loss on the mesial root. The tooth was hemisected and restored with a mesially cantilevered full ceramic crown. Case 2 presents with root caries on an endodontically treated tooth 46 on a patient with bruxism, with an inadequate ferrule on the distal segment. The tooth was hemisected utilizing the socket preservation technique, and the tooth was restored with a conventional fixed-fixed bridge with a second abutment on tooth 47.

Introduction: Root canal treatment (RCT) and its coronal restoration should be regularly assessed to ensure a successful treatment outcome. The aim of the current study is to evaluate the relationship between the obturation technical quality and coronal restoration in the clinical and radiographic outcome of RCT provided by Malaysian undergraduate students. Materials and Methods: A total of 143 root-treated teeth from 136 patients were evaluated through clinical examinations and periapical radiographs with a mean follow-up period of 2.4 (standard deviation = 1.59) years. The quality of the coronal restoration was classified according to modified United States Public Health Service criteria and the technical quality of the obturation was assessed based on two variables: length and density. Periapical status was evaluated according to periapical index scores. Results: About 64% of the teeth were classified as healthy with a significant reduction of apical periodontitis from 70.3% preoperatively to 36% at reassessment (P < 0.001). About 92.1% of obturation was of acceptable length, whereas 5% underfilled and 2.9% overfilled. Teeth with acceptable obturation length were five times less likely associated with apical periodontitis than the inadequately filled ones. 90% of canals had adequate obturation density with no significant association to apical periodontitis. Teeth restored with intracoronal restorations had 50% more chance of developing apical periodontitis. Inadequately restored teeth and teeth with poor obturation quality were associated with three times more likely apical periodontitis occurrence. The quality of endodontic treatment and the coronal restoration significantly influenced the periapical status (P < 0.001). Conclusion: The radiographic obturation quality and coronal restorations of the RCTs performed by the undergraduate students in a Malaysian public dental school were acceptable in 63.8% of cases with a 64% favorable outcome.

Objective: This study aimed to evaluate the first endodontic case experiences, self-confidence levels, and perceptions toward endodontic learning of final-year undergraduate students. Methods: An online questionnaire was emailed to 270 final-year dental students at 10 Malaysian dental schools. The questionnaire consists of 29 questions on students’ experience, self-confidence, and perception toward endodontic learning. Results: The response rate was 74.4%. The most frequently treated case was tooth diagnosed as nonvital associated with periapical periodontitis. Most of the students perceived working length determination as the most difficult stage and reported having low confidence in locating canal orifices in multirooted teeth and achieving satisfactory obturation. Overall, the students were satisfied with the endodontic knowledge taught by their respective faculties. Conclusion: Endodontic teaching in Malaysian dental schools was perceived as satisfactory by most dental students. Although endodontic treatment is perceived as difficult, students demonstrated high confidence in carrying out this treatment. However, they had limited ability in treating the complex root canal system.

Aim Online survey was conducted to investigate the state of undergraduate endodontic clinical training in Malaysian dental schools. Methods An online questionnaire and a cover letter were emailed to the deans of 13 Malaysian dental schools. The questionnaire covers various aspects of endodontic clinical training including teaching methods, endodontic clinical procedures, minimum requirements, clinical sessions and teaching staff. Results The response rate was 69%. Similarities in teaching methods were observed in all responding schools. All schools taught contemporary root canal treatment procedures, including the utilisation of radiograph and electronic apex locator for working length determination, the crown-down approach for canal preparation and the cold lateral compaction for obturation. Sodium hypochlorite solution and non-setting calcium hydroxide medicament were used in most dental schools. Variations were observed in terms of the number of clinical requirements, supervisor: student ratio, and availability of endodontic specialists. The use of engine-driven instruments was observed mainly in government-funded dental schools. Conclusions The majority of dental schools in Malaysia are adopting the European Society Endodontology recommendation for undergraduate endodontic training, particularly in relation to the surveyed aspects. Most of the government-funded dental schools have progressed towards engaging contemporary endodontics with their increasing application of engine-driven Ni-Ti instruments and 3D imaging techniques. Appointments of full-time endodontic specialists would further enhance the quality of endodontic teaching and permit the utilisation of contemporary endodontic materials.