Root perforations


Maintaining the integrity of the natural dentition is essential for full function and natural esthetics. Endodontic therapy can play a vital role in achieving this goal. Technical problems do occur occasionally during endodontic treatment, one of which is perforation of the root canal wall during mechanical debridement. This can significantly impact the long-term prognosis of the tooth. Perforations may be induced by iatrogenic causes, resorptive processes, or caries.

Treatment of endodontic perforation depends on recognition of the condition, clinician training and experience, location and size of the perforation, and the timing of the therapeutic intervention. Depending upon the size and location of the perforation, repair may be achieved either through a conservative, non-surgical technique or by employing surgical intervention. In all cases, these defects must be sealed to prevent the exodus of noxious elements from within the tooth that can further irritate the associated periodontal tissues.

In endodontics, various materials have been used for root repair: amalgam, zinc oxide eugenol, calcium hydroxide, composites and glass-ionomers. However, none of these are ideal for the special conditions and requirements of root repair. To be a superior root repair material, a substance has to have the following qualities:
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Resistance to marginal leakage
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Allows normal healing response
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Ease of clinical manipulation
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Doesn’t leave a shadow on the tooth

Root perforations adversely affect the prognosis of teeth. Inadequacy of the repair materials has been a contributing factor to the poor outcome of repair procedures. Mineral trioxide aggregate (MTA) is a relatively new material that is being successfully used to repair perforations.

See also:
DiaRoot

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