Root perforation and bioceramic. Tooth 21 with chronic apical abscess, periapical radiolucent image and perforation caused by intraradicular retainer.
We opted for paraendodontic surgery, with preparation of the perforation area and retropreparation with ultrasound tips, followed by sealing and retrofilling with Bio C Repair.
In: Mamede Neto el al. Use of MTA-based cement in the treatment of root perforation: clinical case report. Rev Odontol Bras Central 2012;21(59).
INTRODUCTION
During the different stages of endodontic treatment, accidents and complications can occur due to the complexity of the internal dental anatomy, lack of knowledge of the mechanical properties of endodontic instruments, inadequate technical sequence and poor professional skills1 . Among the accidents and complications, the most frequent are deviations
from the root canal (step and apical transportation), fracture of the endodontic instruments and root perforation. Root perforation is defined as an artificial opening caused by iatrogenic etiology or pathological conditions (caries or resorption)3 , resulting in communication between the pulp cavity and periodontal tissue and alveolar bone.
Root perforation and bioceramics. It occurs mainly on the floor of the pulp chamber in an attempt to locate the root canals, in curved and calcified canals, and in situations of inadequate preparation of the prosthetic space for posts in endodontically treated teeth6 . They are considered the second biggest cause of failure and account for around 9.6% of endodontic treatment failures.
Just as important as the emergence of equipment is the discovery of new dental materials. Historically,
zinc oxide, superEBA, silver amalgam, cavit, glass ionomer and calcium hydroxide have been used to seal root perforations, with varying results. Following this trend, Lee et al. (1993) were the first authors to scientifically report the use of a new material indicated for perforations in human teeth: MTA (Mineral Trioxide Aggregate). Since then, this material has been widely investigated and the results have shown excellent physical, chemical and biological properties.
MTA has attracted the attention of many researchers, mainly because it is a hydrophilic material that takes hold in the presence of water, an extremely important property for any dental cement15. A patent was applied for in 1995,
, and from then on it was marketed under the name ProRoot MTA® (Tulsa Dental Products, Tulsa, OK, USA). It states that this material is a common Portland cement, with a higher degree of fineness and the presence of bismuth oxide as a radiopacifying agent16. Faced with expectations of further improving the desirable properties of these cements,
derivations of these materials have appeared on the market. MTA Ângelus® cement, for example, is made up of 80%
Portland cement and 20% bismuth oxide.
Root drilling and bioceramics
