Perforation repair of a primary tooth: a 1-year follow-up case report
DOI:
https://doi.org/10.2478/AMB-2025-0062Keywords:
primary teeth, perforation, mineral trioxide aggregate, case reportAbstract
Aim and Background: Primary teeth are more susceptible to perforation during endodontic treatment due to their anatomical features. Perforations, unintended communications between the root canal and external root surface, are a common procedural accident in endodontics, often leading to tooth loss. Managing these perforations in primary teeth is challenging, with prognosis dependent on factors such as location, size, and contamination. Traditional sealing materials have limitations like microleakage and toxicity. Mineral trioxide aggregate (MTA) is superior due to its sealing ability, biocompatibility, and promotion of hard tissue formation. Case Presentation: This case report describes a furcal perforation repair in a primary molar using MTA in a 5-year-old child. Repulpectomy with calcium hydroxide based obturating material was performed. Follow up was done at 3, 6 months and 1 year. Conclusion: With availability of bioactive materials like MTA, perforations in primary teeth can be repaired with good clinical and radiographic success. Clinical significance: As stated the best space maintainer is the primary tooth by itself. Therefore, perforation repair with MTA can be a viable alternative to extraction in young children thus the tooth can be preserved and meet the functional demands.
References
Ingle JI. A standardized endodontic technique utilizing newly designed instruments and filling materials. Oral Surg Oral Med Oral Pathol 1961;14:83-91.
Clauder T. Present status and future directions – Managing perforations. International Endodontic Journal 2022; 55:872-91.
Tsesis I, Fuss Z. Diagnosis and treatment of accidental root perforations. Endod Top 2006; 13:95-107.
Alshehri MM, Alhawsawi BF, Alghamdi A, et al. The management of root perforation: a review of the literature. Cureus 2024;16(10):e72296.
Bapat RA, Parolia A, Chaubal T, et al. Recent update on potential cytotoxicity, biocompatibility and preventive measures of biomaterials used in dentistry. Biomaterials science. 2021; 9(9):3244-83.
Andrei M, Vacaru RP, Coricovac A, et al. The effect of calcium-silicate cements on reparative dentinogenesis following direct pulp capping on animal models. Molecules. 2021; 26(9):2725.
Oliveira TM, Sakai VT, Silva TC, et al. Repair of furcal perforation treated with mineral trioxide aggregate in a primary molar tooth: 20-month follow- up. Journal of Dentistry for Children. 2008; 75(2):188-91.
Tsatsas DV, Meliou HA, Kerezoudis NP. Sealing effectiveness of materials used in furcation perforation in vitro. International dental journal. 2005; 55(3):133-41.
Clauder T, SHIN SJ. Repair of perforations with MTA: clinical applications and mechanisms of action. Endodontic Topics. 2006;15(1):32-55.
Kaklamanos EG, Lazaridou D, Tsiantou D, et al. Dental arch spatial changes after premature loss of first primary molars: a systematic review of controlled studies. Odontology. 2017; 105(3): 364-74.
De-Deus G, Reis C, Brandão C, et al. The ability of Portland cement, MTA, and MTA Bio to prevent through-and-through fluid movement in repaired furcal perforations. J Endod. 2007; 33(11): 1374-7.
Ma X, Xu H, Chen X, et al. Modern methods and materials used to treat root perforation: effectiveness comparison. Journal of Materials Science: Materials in Medicine. 2024; 35(1):1.
Joffe E. Use of mineral trioxide aggregate (MTA) in root repairs: clinical cases. NYSDJ 2022; 68(6): 34-6
Jeevani E, Jayaprakash T, Bolla N, et al. Evaluation of sealing ability of MM-MTA, Endosequence, and biodentine as furcation repair materials: UV spectrophotometric analysis. Journal of Conservative Dentistry. 2014; 17(4):340-3.
Marques NC, Lourenço Neto N, Oliveira TM. Immediate and mediate furcal perforation treatment in primary molars: 24-month follow-up. European Archives of Paediatric Dentistry. 2016; 17:489-94.
Unal GC, Maden M, Isidan T. Repair of furcal iatrogenic perforation with mineral trioxide aggregate: two years follow-up of two cases. Eur J Dent. 2010;4:475–81
Paulo CR, Marques JA, Sequeira DB, Diogo P, Paiva R, Palma PJ, Santos JM. Influence of blood contamination on push-out bond strength of three calcium silicate-based materials to root dentin. Applied Sciences. 2021;11(15):6849.
Al-Daafas A, Al-Nazhan S. Histological evaluation ofcontaminated furcal perforation in dogs’ teeth repairedby MTA with or without internal matrix. Oral SurgOral Med Oral Pathol Oral Radiol Endod 2007: 103:e92-e99.
Jawami A, Soo E. Iatrogenic extrusion of calcium silicate cements on teeth associated with large periapical lesion: a case report with 12-month follow-up. J Dent Indones. 2022;29(2):154-9.
Pitt Ford TR, Torabinejad M, McKendry DJ, et al. Use of mineral trioxide aggregate for repair of furcal perforations. Oral Surg Oral MedOral Pathol Oral Radiol Endod 1995: 79: 756-763.
Li J-y, He S-y, Wang P-x, et al. Incidence and risk factors of unplanned retreatment following dental general anesthesia in children with severe early childhood caries. Front. Pediatr 2023. 11:1163368.
Dean JA, editor. McDonald and Avery’s Dentistry for the Child and Adolescent: McDonald and Avery’s Dentistry for the Child and Adolescent-E-Book. Elsevier Health Sciences; 2021 Feb 2.
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Copyright (c) 2025 P. Sushmitha, A. P. Nayak, Y. M. Karuna, C. Thimmaiah (Author)
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Journal Acta Medica Bulgarica 
