Single-visit endodontic management of iatrogenic supracrestal root perforation associated with dual sinus using MTA and collagen

Abstract

Iatrogenic perforation is usually an undesired complication that results in an artificial communication between the root canal system to the supporting tissues of the teeth or to the oral cavity. It can occur during preparation of endodontic access cavities and exploration of calcified canal orifices. Successful treatment depends on the proper diagnosis and immediate sealing of the perforation site to eliminate the risk of infection. On the basis of the physical and biologic properties, mineral trioxide aggregate (MTA) has shown superior sealing ability and is suitable for closing the perforation site. The purpose of this case report is to describe the successful orthograde retreatment of iatrogenically perforated lower central incisor associated with dual sinuses. The perforation site was cleaned with 5.25% sodium hypochlorite and 0.9% normal saline solution and sealed with MTA with an internal collagen matrix. Finally, the tooth was endodontically treated and coronally restored with composite resin. After 6 and 12 months of follow-up, the absence of periradicular radiolucent lesion, disappearance of dual sinus, pain and swelling indicated a successful outcome of non-surgical sealing of the perforation.