Treatment of Cervical Root Perforation Using MTA - case report
DOI:
https://doi.org/10.33448/rsd-v11i2.25474Keywords:
Endodontics; Biomedical and Dental Materials; Root Canal Therapy.Abstract
Introduction: Root perforation is an accident characterized by the communication between the pulp space or root canal with the periodontal tissues that support the dental element. This type of complication can happen due to extensive caries, root resorption or even due to the incorrect use of burs and other endodontic instruments. The present study aimed to report a clinical case in which the endodontic treatment of a dental element with root perforation was performed, using MTA to seal the perforation. Case report: Male patient, 29 years old, was referred to the specialization clinic for continuation and endodontic treatment. The radiographic examination showed thickening of the periodontal ligament space in the apical region and a radiolucent area in the coronary region suggestive of root perforation, clinically confirmed with the use of an electronic foraminal locator. In the first session, chemical-surgical preparation and use of intracanal medication were performed. In the following session, the root perforation was closed with the use of gray MTA, followed by the filling of the canal. Final considerations: Appropriate clinical management, with the use of technology and equipment that aid in the diagnosis, as well as the use of the most suitable materials for the treatment of root perforations, are essential to obtain favorable clinical results.
References
Alrahabi, M., Zafar, M. S., & Adanir, N. (2019). Aspects of Clinical Malpractice in Endodontics. European Journal of Dentistry, 13(3), 450–458. https://doi.org/10.1055/S-0039-1700767
Camilleri, J., & Pitt Ford, T. R. (2006). Mineral trioxide aggregate: a review of the constituents and biological properties of the material. International Endodontic Journal, 39(10), 747–754. https://doi.org/10.1111/J.1365-2591.2006.01135.X
D’Assunção, F. L. C., de Albuquerque, D. S., Salazar-Silva, J. R., de Queiroz Ferreira, L. C., & Bezerra, P. M. (2007). The accuracy of root canal measurements using the Mini Apex Locator and Root ZX-II: an evaluation in vitro. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology and Endodontology, 104(3). https://doi.org/10.1016/j.tripleo.2007.03.025
D’Assunção, F. L. C., Sousa, J. C. N., Felinto, K. C. A., De Medeiros, T. C., Leite, D. T., De Lucena, R. B., & De Oliveira Lima, J. (2014). Accuracy and repeatability of 3 apex locators in locating root canal perforations: An ex vivo study. Journal of Endodontics, 40(8), 1241–1244. https://doi.org/10.1016/j.joen.2014.02.004
Dawood, A. E., Parashos, P., Wong, R. H. K., Reynolds, E. C., & Manton, D. J. (2017). Calcium silicate-based cements: composition, properties, and clinical applications. Journal of Investigative and Clinical Dentistry, 8(2), 1–15. https://doi.org/10.1111/jicd.12195
Dreger, L. A. S., Felippe, W. T., Reyes-Carmona, J. F., Felippe, G. S., Bortoluzzi, E. A., & Felippe, M. C. S. (2012). Mineral trioxide aggregate and Portland cement promote biomineralization in vivo. Journal of Endodontics, 38(3), 324–329. https://doi.org/10.1016/J.JOEN.2011.11.006
Estrela, C., De Almeida Decurcio, D., Fedele Rossi, G., Almeida Silva, J., Aguirre Guedes, O., & Henrique Borges, Á. (2018). Root perforations : a review of diagnosis , prognosis and materials. Brazilian Oral Research, 32(1), 133–146.
Estrela, C., Pécora, J. D., Estrela, C. R. A., Guedes, O. A., Silva, B. S. F., Soares, C. J., & Sousa-Neto, M. D. (2017). Common operative procedural errors and clinical factors associated with root canal treatment. Brazilian Dental Journal, 28(2), 179–190. https://doi.org/10.1590/0103-6440201702451
Evans, M. D. (2021). A Contemporary Treatment of an Iatrogenic Root Perforation: A Case Report. Journal of Endodontics, 47(3), 520–525. https://doi.org/10.1016/J.JOEN.2020.11.002
Fuss, Z., & Trope, M. (1996). Root perforations: classification and treatment choices based on prognostic factors. Endodontics & Dental Traumatology, 12(6), 255–264. https://doi.org/10.1111/J.1600-9657.1996.TB00524.X
Fuss, Zvi, Assooline, L. S., & Kaufman, A. Y. (1996). Determination of location of root perforations by electronic apex locators. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics, 82(3), 324–329. https://doi.org/10.1016/S1079-2104(96)80361-1
Glossary of Endodontic Terms - American Association of Endodontists. (n.d.). Retrieved January 10, 2022, from https://www.aae.org/specialty/clinical-resources/glossary-endodontic-terms/
Gonzalez, A. (1990). [Diagnosis and treatment of accidents and complications in endodontics]. Acta Clinica Odontologica : Organo de Difusion Academica de Sociedad Antioquena de Endodoncistas ... [et Al.], 13(26), 25–34. https://pubmed.ncbi.nlm.nih.gov/2135764/
Kaufman, A. Y., Fuss, Z., Keila, S., & Waxenberg, S. (1997). Reliability of different electronic apex locators to detect root perforations in vitro. International Endodontic Journal, 30(6), 403–407. https://doi.org/10.1046/J.1365-2591.1997.00107.X
Marroquín, B. B., Fernández, C. C., Schmidtmann, I., Willershausen, B., & Goldberg, F. (2014). Accuracy of electronic apex locators to detect root canal perforations with inserted metallic posts: an ex vivo study. Head & Face Medicine, 10, 57. https://doi.org/10.1186/s13005-014-0057-2
Pereira, A. S., Shitsuka, D. M., Parreira, F. J., & Shitsuka, R. (2018). Metodologia da pesquisa científica.[e-book]. Santa Maria. Ed. UAB/NTE/UFSM. Disponível em: https://repositorio. ufsm. br/bitstream/handle/1/15824/Lic_Computacao_Metodologia-Pesquisa-Cientifica.pdf
Rodríguez, G., Abella, F., Durán-Sindreu, F., Patel, S., & Roig, M. (2017). Influence of Cone-beam Computed Tomography in Clinical Decision Making among Specialists. Journal of Endodontics, 43(2), 194–199. https://doi.org/10.1016/j.joen.2016.10.012
Schmidt, B. S., Zaccara, I. M., Reis Só, M. V., Kuga, M. C., Palma-DIbb, R. G., & Poli Kopper, P. M. (2016). Influence of operating microscope in the sealing of cervical perforations. Journal of Conservative Dentistry, 19(2), 152. https://doi.org/10.4103/0972-0707.178695
Seltzer, S., Sinai, I., & August, D. (1970). Periodontal effects of root perforations before and during endodontic procedures. Journal of Dental Research, 49(2), 332–339. https://doi.org/10.1177/00220345700490022301
Tawil, P. Z., Duggan, D. J., & Galicia, J. C. (2015). Mineral trioxide aggregate (MTA): its history, composition, and clinical applications. Compendium of Continuing Education in Dentistry (Jamesburg, N.J. : 1995), 36(4). https://pubmed.ncbi.nlm.nih.gov/25821936/
Tsesis, I., & Fuss, Z. (2006). Diagnosis and treatment of accidental root perforations. Endodontic Topics, 13(1), 95–107. https://doi.org/10.1111/J.1601-1546.2006.00213.X
Tsesis, I., Rosenberg, E., Faivishevsky, V., Kfir, A., Katz, M., & Rosen, E. (2010). Prevalence and associated periodontal status of teeth with root perforation: a retrospective study of 2,002 patients’ medical records. Journal of Endodontics, 36(5), 797–800. https://doi.org/10.1016/J.JOEN.2010.02.012
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2022 George Táccio de Miranda Candeiro; Amanda Mourão Ley Barros; Samilla dos Santos Gonçalves Monteiro; Hermano Camelo Paiva; Luciana Maria Arcanjo Frota; Luiza Riomar Paz; Luiz Carlos Costa Madeira Alves; Antônio Sérgio Teixeira de Menezes
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
1) Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
2) Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
3) Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.