A 55-year-old man with severe right-sided empyema was admitted to our hospital. Six days before this admission, he had undergone upper GI endoscopy in another center to remove a retained chicken bone in lower esophagus and despite documented thoracic esophageal PERFORATION, treatment was surprisingly delayed. The PERFORATION was closed with primary sutures and reinforced with intercostal muscle flap wrap and pleural patch. Esophagography performed 3 weeks after the operation showed a well-healed esophagus without stenosis or leakage. We conclude that regardless of the time interval between the injury and the operation, reinforced primary REPAIR is recommended for non-malignant thoracic esophageal PERFORATION and provide a one-stage operation with preservation of the native esophagus. As far as we know, this type of procedure (with regard to its underlying infected body region and considerable controversy in delayed esophageal PERFORATION management) has not been previously performed in Iran.

Treatment of tympanic membrane PERFORATION > 3mm diameter by use of polyurethane sheet had been relatively successful, but for PERFORATION larger than 3 MM, myringoplasty using connective tissue, is needed.The aim of this research was the REPAIR of tympanic membrane PERFORATION larger than three mm by use of polyurethane graft.In this experimental study 19 patients with dry tympanic membrane PERFORATION larger than 3 mm were selected and treated by polyuret1mnesheet after excision of PERFORATION rim and application of polyurethane solution human albumin 200/0as adhesive tool. Results showed that PERFORATION REPAIRed by neotympanium connation in 10.4% of the cases, and failure of graft observed in 73.6% of them. In spite of efficacy of polyurethane in mesodennal tissues, its application is not recommended for REPAIR of tympanic membrane PERFORATION.

Introduction: Root PERFORATION is an endodontic procedural error. Treatmentof PERFORATION depends on the location and size of PERFORATION, duration of exposure to the oral cavity, patient's cooperation and degree oftissue inflammation. Several materials have been introduced to seal off the PERFORATION. MTA is one of the best materials for this purpose.Case Report: We report the REPAIR of distal root PERFORATION in a primary mandibular second molar of a 9 year-old boy who had congenital absence of the second premolar tooth at the same quadrant. The PERFORATION site was sealed with MTA and the three root canals were filled with gutta percha. Follow up visits at 1, 3, 6, 12, 21 and 24 months showed clinical and radiographic success of treatment.

Iatrogenic PERFORATION of the furcation area in multi-rooted molars during preparation of the access cavity can potentially lead to tooth extraction. The present case report describes the nonsurgical endodontic management of an extensive pulp chamber floor PERFORATION in a first mandibular molar with calcium enriched mixture (CEM) cement. The PERFORATION was chemically cleaned and then physically sealed with CEM cement. Root canal therapy was completed and the tooth was then restored with amalgam. A one-year follow-up revealed the absence of symptoms of infection/inflammation as well as clinical and radiographic signs/symptoms and therefore, can be interpreted as a favorable treatment outcome.

Article Type: Case Report The present report reviews the diagnostic and treatment challenges of a mandibular molar with previous root canal treatment and signs of a procedural mishap, i.e. furcal radiolucency and localized swelling of the gingival margin in which a sinus tract was present. By tracing the sinus tract, it became evident that the lesion originated from the furcation area, not the root apices. This case was treated by cleaning/filling the coronal half of the canals and leaving the rest of obturating material untouched. The strip PERFORATION zone in the mesial root was sealed off with calcium-enriched mixture cement. One week after treatment, the patient’s symptoms had faded away and one year later, the lesion completely healed with bone replacement.

Teeth with furcal PERFORATION present difficult resolution and dubious prognosis. Several materials have been proposed and calcium silicate-based cements such as mineral trioxide aggregate (MTA) are the most recommended. However, its longterm clinical behavior still remains poorly understood. The present study reports a clinical case of furcal PERFORATION REPAIR using Angelus MTA, with a 7-year follow-up. Patient sought treatment 2 months after iatrogenic accident. First lower right molar presented clinical signs such as fistula and bone loss between mesial and distal roots. Firstly, all root canals were treated and then furcal PERFORATION was sealed with MTA Angelus and the dental crown was restored with composite resin. Radiographic evaluation was immediately performed to analyze the furcal PERFORATION filling. After 7 years, a new clinical and imaging evaluation using periapical radiography and cone-beam computed tomography (CBCT) showed absence of clinical signs and symptoms, and alveolar bone reconstitution with periodontal space reduction. Angelus MTA presented good clinical behavior in the iatrogenic furcal PERFORATION resolution based on long-term clinical evidence.