Management of perforations: four cases from two private practices with medium- to long-term recalls.

By Ree M, Schwartz R.

Date: 01/2012
Journal: JOE

Purpose:

  • Present 4 clinical cases of perforation repair with medium to long-term recalls.

Materials/Methods:

  • N= 4 cases.
  • Three nonsurgical cases were retreated, repaired with mineral trioxide aggregate, and restored. The fourth case was strictly a surgical repair. Recalls up to 13 years are presented.

Results:

  • Patient 1 – 13 year old female. Periapical radiolucency associated with the mesial root of tooth #19. In addition, the mesiobuccal canal appeared to be transported and perforated.
  • Patient 2 – 41 year old female. Tooth #2. Apical and lateral radiolucency associated with the mesiobuccal root and a midroot perforation with extrusion of the filling material. The apical portion of the mesiobuccal root was not filled.
  • Patient 3 – 51 year old female. Tooth#7. A mixture of blood and pus appeared immediately in the post space. After the drainage stopped, the post space was irrigated and dried and inspected under the microscope. It was decided to proceed with treatment. Shortly thereafter, the crown debonded from the tooth.
  • Patient 4 – 46 year old male. Tooth#7. During root canal treatment in 1984, perforation had occurred during post space preparation. The canal space and perforation were filled with gutta-percha and sealer. A cast post and core were fabricated and cemented, and a metal-ceramic crown was placed.

Clinical Significance:

If managed properly, perforation repairs can result in long-term clinical success.