This report describes management of furcal perforation in mandibular first molar by bicuspidization and regeneration of bone using an osseograft. 45 years male individual was reported having inflammation in the right mandibular posterior region of the jaw with periodic exacerbation and remission. On examination, sinus opening was found in relation to buccal side of 46. Radiographic examination revealed radiolucency and radio-opaque mass in the furcation area of 46 suggestive of foreign body. The patient was diagnosed of primary endodontic involvement with secondary periodontal lesion of tooth 46. Antibiotic coverage followed by abscess drainage of 46 was done. Surgical procedure was scheduled with bicuspidizaton technique and bone grafting. After the thorough debridement, the furcation defect was filled with an osseograft. Subsequently, 6 week later, toot preparation for porcelain fused to metal restorations was performed on dissected portions. Post operatively, the patient follow up was done at 1 st month, 2 nd month and 6 th month.
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