Endodontic Perforation Closure by Five Mineral Oxides Silicate-Based Cement with/without Collagen Sponge Matrix

Abstract

Endodontic perforations are common accidents that occasionally happen as a result of misuse or difficult anatomy of some teeth; it may lead to teeth loss unless a good management is provided. Bioceramic (silicate-based) cements like mineral trioxide aggregate have a big role in management of such accidents. This case report aimed to evaluate the ability of five mineral oxides cement “5MO” in sealing two root canal perforations (furcation and postdrill perforations) and inducing clinical and radiographic healing in the periodontal tissues with/without the use of collagen sponge matrix. A 58-year-old healthy female was referred to our dental office complaining of severe pain in the upper left premolars’ region. Periapical radiographic examination revealed unsatisfactory root canal treatment of the teeth #24 and #25 with a furcation perforation and a postdrill perforation, respectively. Cone-beam computed tomography “CBCT” scans confirmed the findings of the periapical radiography and revealed the presence of radiolucent lesions surrounding the apex of both teeth #24 and #25. The treatment plan was a nonsurgical root canal retreatment by endodontic access through the full-ceramic crowns. After three years of follow-up, CBCT scans revealed a complete healing and bone formation on both premolars. This case report indicates the use of 5MO cement for endodontic perforations management.

Antimicrobial Action, Genotoxicity, and Morphological Analysis of Three Calcium Silicate-Based Cements

“…There is an involvement of diverse factors including microorganisms, their byproducts, and growth factors [ 20 ]. However, the effective disinfection is not given by the CSCs alone, but by the irrigants, intracanal medications, and the complementary techniques [ 21 – 25 ] highlighting the sealing role of the CSCs [ 2 , 4 , 26 ].…”

“…Finally, the CSCs have a finality of promoting tissue repair in interesting areas for apexogensis, apexification, and apicectomy [ 3 – 5 , 35 ] or sealing of perforated area [ 2 ] and some advantages in vital pulp therapy approaches [ 36 ]. Thus, the most expected of these material are not to be genotoxic, and has antimicrobial action, or to not favor the contamination; still, this action may be improved by the use of antimicrobial agents like sodium hypochlorite and others [ 24 , 37 , 38 ] and by complementary technique like photodynamic therapy and passive ultrasonic irrigation [ 21 , 23 , 25 , 37 ].…”

“…Five mineral oxides (5MO) (Golden Yatti LLC, Muscat, Oman) is a calcium silicate-based cement (CSC), it was introduced firstly as a pulp capping material [ 1 ]. In the literature, there are three case reports evaluated its efficacy in endodontic perforation and open apex sealing [ 2 – 4 ]. However, only one experimental study, in dogs, reported its efficacy as a direct pulp capping material [ 5 ].…”

Biological and chemical properties of five mineral oxides and of mineral trioxide aggregate repair high plasticity: an in vitro study

“…All these CSCs have demonstrated efficient clinical behavior proven in several studies 4 , 5 , 7 , 8 , 13 . However, the antimicrobial action, cytotoxicity, morphological structure, chemical composition, and radiopacity of Five Mineral Oxides (5MO) and MTA Repair HP have been little explored, if at all.…”

Experimental nano calcium aluminate/tri calcium silicate root repair: Synthesis, physical and mechanical properties compared to mineral trioxide aggregate and Biodentine

“…Endodontic perforation is the communication of the root canal system with the periodontium caused by a procedural error during endodontic treatment. Although extensive caries lesions or resorptive processes can also induce perforations, the majority of root perforations occur iatrogenically [1]. Root perforations that result in endodontic treatment failure represent approximately 10% of all unsuccessful cases [2].…”