A clinical and roentgenological study of 55 cases of root perforation

Abstract

The treatment outcome of 55 root perforations in man were related to pretreatment conditions and various treatment procedures used, with a mean recall period of 3 years 5 months. In this study maxillary teeth were perforated three times more often (74.5 per cent) than mandibular teeth (25.5 per cent); 47 per cent of the perforations were due to endodontic and 53 per cent due to prosthodontic treatment. The buccal and mesial root surfaces as well as the midroot areas were most often perforated. In 25 per cent, radiographic changes were directly related to the perforated areas. Twenty-eight perforations were repaired by orthograde fillings with gutta-percha and Kloro-percha N-phi; eight received a combined orthograde and surgical repair, and in only three cases a surgical approach was used. Four cases received no treatment but were recalled, and twelve perforations showed a size and location hopeless for repair; the teeth were therefore extracted. Five failures of the primary orthograde treatment group later underwent surgical treatment and were followed up for 3 years 3 months. The overall success rate in the primary treatment group of teeth was 56 per cent while 36 per cent became failures. Five failures were retreated, and four of these became successful. A combined orthograde and surgical repair of the perforations provided the most favourable outcome with 92 per cent successful. The study stresses the importance of preventing this type of treatment complication.

Root perforations: classification and treatment choices based on prognostic factors

“…1), as well as during endodontic treatment ( Fig. 2) (3). The frequency of root perforations has been reported to range from 3% to as high as 10% (2,4).…”

Effect of Sodium Hypochlorite on Push-out Bond Strength of Four Calcium Silicate-based Endodontic Materials when used for repairing Perforations on Human Dentin: An in vitro Evaluation

“…It has been reported that 47% of perforations occurred during endodontic treatment. 1 Ideally, a perforation should be repaired with a biocompatible, nonabsorbable, and radiopaque material that should provide a tight seal at the perforation site. Numerous dental materials have been proposed for endodontic perforation repair, including amalgam, phosphate cement, gutta-percha, zinc oxide eugenol, calcium hydroxide, glass-ionomer…”

Repair of perforation with Mineral trioxide aggregate (MTA)

“…According to Kvinnsland et al [1] 53% of iatrogenic perforations occur during insertion of posts and the remaining 47% are induced during routine endodontic treatment. Root perforations which are induced, possess significant complications to endodontic treatment and if not detected and properly treated, the breakdown of the periodontium may ultimately lead to loss of the tooth.…”