Perforation of the root
Perforations represent pathologic or dentist induced communications between the root canal space and the attachment apparatus. Regardless of cause, a perforation is an invasion into the supporting structures that initially incites inflammation and loss of attachment and ultimately may compromise the prognosis of the tooth. In general terms we can define perforation as a hole in the crown or root of the tooth that can occur naturally as a result of decay or other pathosis. A perforation can also be caused by excessive tooth structure removal during root canal preparation by the dentist.
Patient will complain of pain and you can notice bleeding even after thorough cleaning of the root canals .
The causes of perforations are resorptive defects, caries, or iatrogenic events that occur during and after endodontic treatment.
You will first have to repair the perforation site by sealing the hole with suitable filling materials followed by root canal therapy which can often save the tooth.
In general, ProRoot (Dentsply Tulsa Dental) MTA is the restorative material of choice to repair virtually all perforation defects. Other materials which can be used are tricalcium phosphate, hydroxyapatite, calcium hydroxide, glass ionomer cement, composites.
Last updated on 02 December, 2018.