Summary
Root perforation may occur during endodontic procedures compromising both the tooth and periodontium and affecting the long-term prognosis. Crestal level perforations are difficult to manage due to proximity to the epithelial attachment resulting in inflammation, bone resorption and necrosis. Management of root perforations is dependant on time of perforation to repair, location and size. Methods to treat perforations are outlined including the internal matrix concept and use of materials capable of inducing osteogenesis and cementogenesis where applicable.
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References
American Association of Endodontists. Glossary of endodontic terms. 7th ed. Chicago: American Association of Endodontists; 2003. p. 1–51.
Alhadainy HA. Root perforation. A review of the literature. Oral Surg Oral Med Oral Pathol. 1994;78:368–74.
Fuss Z, Trope M. Root perforations: classification and treatment choices based on prognostic factors. Endod Dent Traumatol. 1996;12:255–64.
Torabinejad M, Lemon RR. Procedural accidents. In: Walton RE, Torabinejad M, eds. Principles and Practice of Endodontics, 3rd edn. Philadelphia: WB Saunders, 2002: 312–331.
Kvinnsland I, Oswald RI, Halse A, Gronningdeter AG. A clinical and roetgenotological study of 55 cases or root perforation. Int Endod J. 1989;22:75–84.
Seltzer S, Sinai I, August D. Periodontal effects of root perforations before and during endodontic procedures. J Dent Res. 1970;49(2):332–9.
Lemon RR. Nonsurgical repair of perforation defects. Internal matrix concept. Dent Clin North Am. 1992;36:439–57.
McCabe PS. Avoiding perforations in endodontics. J Ir Dent Assoc. 2006;52:139–48.
Moreinis SA. Avoiding perforation during endodontic access. J Am Dent Assoc. 1979;98:707–12.
Wong R, Cho F. Microscopic management of procedural errors. Dent Clin North Am. 1997;41:455–79.
Fuss Z, Assooline LS, Kaufman AY. Determination of location of root perforations by electronic apex locators. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1996;82:432–9.
Shemesh H, Cristescu RC, Wesselink PR, Wu MK. The use of cone-beam computed tomography and digital periapical radiographs to diagnose root perforations. J Endod. 2011;37:513–6.
Tamse A. Vertical root fractures in endodontically treated teeth: diagnostic signs and clinical management. Endod Top. 2006;13:84–94.
Zhu WC, Gyamfi J, Niu LN, Schoeffel GJ, Liu SY, Santarcangelo F, Khan S, Tay KC, Pashley DH, Tay FR. Anatomy of sodium hypochlorite accidents involving facial ecchymosis – a review. J Dent. 2013;41(11):935–48.
Hartwell GR, England MC. Healing of furcation perforations in primate teeth after repair with decalcified freeze-dried bone: a longitudinal study. J Endod. 1993;19:357–61.
Rafter M, Baker M, Alves M, Daniel J, Remeikis N. Evaluation of healing with the use of an internal matrix to repair furcation perforations. Int Endod J. 2002;35:775–83.
Alhadainy HA, Himel VT, Lee WB, Elbaghdady YM. Use of hydroxyapatite based material and calcium sulfate as artificial floors to repair furcal perforations. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1998;86:723–9.
Bargholtz C. Perforation repair with mineral trioxide aggregate: a modified matrix concept. Int Endod J. 2005;38:59–69.
Dragoo MR. Resin-ionomer and hybrid-ionomer cements: part II – clinical and histological wound healing responses in specific periodontal lesions. Int J Periodontics Restorative Dent. 1997;17:75–87.
Ford TR, Torabinejad M, McKendry DJ, Hong CU, Kariyawasam SP. Use of mineral trioxide aggregate for repair of furcal perforations. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1995;79:756–63.
Holland R, Filho JA, de Souza V, Nery MJ, Bernabe PF, Junior ED. Mineral trioxide aggregate repair of lateral root perforations. J Endod. 2001;27:281–4.
Main C, Mirzayan N, Shabahang S, Torabinejad M. Repair of root perforation using mineral trioxide aggregate: a long term study. J Endod. 2004;30:80–3.
Krupp C, Bargholz C, Brüsehaber M, Hülsmann M. Treatment outcome after repair of root perforations with mineral trioxide aggregate: a retrospective evaluation of 90 teeth. J Endod. 2013;39:1364–8.
Regan JD, Witherspoon DE, Foyle DM. Surgical repair of root and tooth perforations. Endod Top. 2005;11:151–78.
Barkhordar RA, Javid B. Treatment of endodontic perforations by guided tissue regeneration. Gen Dent. 2000;48:422–6.
Pontius V, Pontius O, Braun A, Frankenberger R, Roggendorf MJ. Retrospective evaluation of perforation repairs in 6 private practices. J Endod. 2013;39:1346–58.
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Patel, B. (2016). Iatrogenic Perforations. In: Patel, B. (eds) Endodontic Treatment, Retreatment, and Surgery. Springer, Cham. https://doi.org/10.1007/978-3-319-19476-9_12
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DOI: https://doi.org/10.1007/978-3-319-19476-9_12
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