Nine Months Follow-up of Root Perforation Repair Using MTA-HP in a Single Retreatment Session: A Case Report

Aims: Root perforations are accidents and complications that can occur during endodontic treatment. With the advent of calcium silicate-based repair cements, there is a possibility to effectively seal and preserve the affected tooth. The objective of this case report was to evaluate the success and repair of a root perforation sealed with a calcium silicate-based repair cement of a tooth that had been indicated for extraction.

Presentation of Case: A 59-year-old healthy female without systemic diseases, presented to the dental service with a fistula, spontaneous pain, and pain upon vertical and horizontal percussion in the tooth 24, which had a metal-ceramic crown, a metal post, and inadequate endodontic treatment. The crown was sectioned, and the post was removed with ultrasonic tips. A perforation in the palatal root and bone resorption were observed through a cone-beam computed tomography (CBCT). The perforation was sealed with MTA HP (Angelus) and the canals were retreated using mechanized systems and filled with BioRoot RCS sealer (Sepdotont) in a single session. The tooth was rehabilitated using a digital workflow based on scanning and 3D printing of the restoration/crown. Follow-up was performed after six and nine months, and the patient showed no painful symptoms upon horizontal and vertical percussion tests, with CBCT showing regression of the bone resorption.

Discussion and Conclusion: The bone repair and the absence of signs and symptoms of periradicular pathologies indicate treatment success after nine months follow up of the root perforation sealed with a calcium silicate-based repair cement.