“Mid-root perforation repair with Mineral Trioxide Aggregate and Endodontic rehabilitation with Fibre Reinforced Post- A Case Report”

Abstract

Root perforations can occur as a consequence of pathological processes or during routine endodontic treatment that can result in significantly compromised endodontic treatment outcomes, especially when bacterial infection is allowed to establish with the seal between the root canal obturation material and the periradicular tissue is compromised. Hence, one of the most difficult challenges in dentistry is the reconstruction of an endodontically treated tooth with perforation, maintaining aesthetics and functional integrity. Mid-root perforations can be further complicated by its close proximity to the gingival sulcus, pre-empting proper precautions to avoid future contamination. Use of the proper biomaterial, along with adhesive posts enhances the longevity of such compromised teeth. This case report describes the successful management of iatrogenic root perforation in an endodontically treated maxillary central incisor with Mineral Tri-oxide Aggregate, as well as the use of Fibre-reinforced composite post for composite core build-up to enhance the strength and fracture resistance of the tooth. During the first appointment the sealing of the perforation defect was achieved with the placement of Mineral Trioxide Aggregate.  On the second appointment,  post space preparation was done  followed by luting of the fibre post using dual cure resin luting cement and Composite resin was layered around the post to form the core. Tooth preparation was carried out and during the subsequent appointment, Zirconia crown was cemented with dual cure resin luting cement. The patient was regularly recalled for follow up visits during which the tooth remained asymptomatic clinically and significant healing was observed radiographically.