ENDODONTICS
ENDODONTIC RETREATMENT USING MTA-BASED SEALANTS IN A TOOTH WITH
PERFORATION AND PERIAPIAL LESION: A CLINICAL CASE REPORT
Nayara Rodrigues Nascimento Oliveira Tavares 1a , Maria Antonieta Veloso Carvalho de Oliveira 1b* , Lucas do Nascimento
Tavares 1c , Alexia da Mata Galvão 1d , Cristiane Melo Caram 1e , Gisele Rodrigues da Silva 1f
Department of Endodontics, School of Dentistry, Federal University of Uberlândia, Uberlândia, MG, 38400-902-Brazil
1
DDS, PhD
DDS, Especialist
c
DDS, Ms
d
DDS, Ms
e
DDS, Ms
f
DDS, PhD
a
b
Received: October 25, 2017
Revised: November 08, 2017
Accepted: November 27, 2017
Published: November 28, 2017
Academic Editor: Paula Perlea, DMD, PhD, Associate Professor, “Carol Davila” University of Medicine and Pharmacy Bucharest, Bucharest, Romania
Cite this article:
Rodrigues Nascimento Oliveira Tavares N, Veloso Carvalho de Oliveira MA, do Nascimento Tavares L, da Mata Galvão A, Melo Caram C, Rodrigues da
Silva G. Endodontic retreatment using MTA-based sealants in a tooth with perforation and periapical lesion. Stoma Edu J. 2017;4(4):300-303
ABSTRACT
DOI: 10.25241/stomaeduj.2017.4(4).art.7
Introduction: To report an endodontic retreatment with a root perforation and use of reparative
cement and filling sealant based on mineral trioxide aggregate (MTA).
Summary: Retreatment in teeth with root perforations can reduce the longevity of the treatment,
because it depends on the rapid location and proper sealing, with biocompatible materials that
promote tissue repair. A female patient came to the dental office complaining of pain in tooth 36,
with an indication of retreatment on it. Radiographically, it presented thickening of the periodontal
ligament and periapical lesion in the mesial and distal roots, leading to the diagnosis of chronic
apical periodontitis. With the help of an operative microscope, it was possible to find a perforation
in the most cervical portion in the furcation region of the mesio-vestibular root canal. To treat this
perforation, it was filled with MTA HP Repair, to enable preparation of root canals and subsequent
filling with MTA Fillapex, through the Schilder Plus technique and execution of a 12mm relief on
distal root for placement of the intra-radicular retainer. Rehabilitation of teeth with root perforations
can be performed with MTA-based filling sealants, presenting satisfactory results for repairs in cases
of perforations and periapical lesions.
Key learning points:
- Root perforations are accidental unwanted complications that can occur in stages of the endodontic
treatment;
- The prognosis for endodontic perforations depends on the size and location of the defect and how
quickly the perforated area was sealed with biocompatible material.
Keywords: mineral trioxide aggregate, root canal filling materials, periapical periodontitis.
1. Introduction
Root perforations are accidental unwanted
complications that can occur in stages of the
Endodontic treatment, as preparation of the access
cavity and preparation of the root canal, or as a
result of the extension of resorption or iatrogenic
procedures. 1 Of these, 53% of iatrogenic perforations
occur during the insertion of intra radicular retainers
and the remaining 47% are induced during routine
endodontic treatment. 2
One of the most important causes of failure in
endodontic treatment is the dental perforation at
different places, among which the perforations
in the furcation region have the worst prognosis.
Perforations lead to inflammatory response in the
periodontal region, which can cause irreversible
damage of the periodontal ligament or even dental
loss. 3
The prognosis for endodontic perforations depends
on the size and location of the defect and how quickly
the perforated area was sealed with biocompatible
material. A variety of materials such as zinc-oxide
eugenol, amalgam, Cavit, composite resin, glass
ionomer and mineral trioxide aggregate (MTA) have
been suggested to seal these perforations. 2,3,4
The introduction of MTA by Torabinejad in 1993
had a great impact on the endodontic practice,
increasing the treatment success rates. In addition
to its superior sealing properties, studies have
shown that MTA has excellent biocompatibility when
placed in contact with the periradicular tissues. 2,5 It
was initially recommended as filling material, but
*Corresponding author:
Dr Maria Antonieta Veloso Carvalho de Oliveira, DDS, PhD, Department of Endodontics, School of Dentistry, Federal University of Uberlândia, Avenida Pará 1720, Campus Umuarama, Bloco 4L, Sala 4LA 28,
Uberlândia, MG, 38400-902-Brazil, Tel/Fax: +55 34 32258103, e-mail: [email protected]
300
Stoma Edu J. 2017;4(4): 300-303
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