Purpose: To present the etiology and location of root perforations, and to relate their outcome
to the pretreatment conditions and various procedures used to treat the perforations
N= 55 root perforations were recorded over a period of 11 years
Materials and Methods:
•Recall for all patients with perforation repair for radiographic evaluation •Mean recall period 3,5 years:
oSuccess: normal PDL width, lamina dura is continuous
oUncertain: PDL space twice-normal thickness. A radiolucency reduced in size but has not resolved during a postoperative period < 2 years.
oFailure: radiolucency unchanged or has increased in size. The radiolucency has reduced in size but has not resolved ≥2 years postoperatively, or lesion had developed.
Results:
•Perforations were more common in the maxilla (73%) than in the mandible (27%)
•In the maxillary arch, canine was the most frequently perforated tooth, followed by the lateral incisor.
•In the mandibular arch, the first molar was the most
•Buccal (35%) and mesial (35%) root surfaces were most frequently perforated
Etiology:
A) During endodontic treatment: 47%, mostly in the midroot level or apical third •Attempting to negotiate calcified canals 42%
•Root canal instrumentation 35%
•Attempting to locate canal orifices 23%
B) During post preparation: 53%, mostly in the midroot level.
•The overall success rate (for the 39 treated cases): 56%, and failure rate: 36%
Prognosis: •Treatment success when perforations are in the apical part of roots greater than those located coronally
Treatment outcome in relation to type of treatment performed:
•Highest success rate was found when combined orthograde and surgical treatment were performed.
•When s treated only with orthograde, 5 cases were diagnosed in the recall as failure. After surgical treatmen, the success rate of this method (orthograde + surgical) would be considered 92%.
Clinical significance:
•Repairing root perforations has favorable results, especially when combined orthograde and surgical approach is performed
•Perforation repair success could reach above 50%