Repair of a furcation perforation with mineral trioxide aggregate: A case report with 6 year follow-ups

BACKGROUND AND AIM: One of the most common reasons for the failure of endodontic treatment is root perforation. Perforations might occur due to carious lesions, tooth resorption or they might be iatrogenic during endodontic treatment or in most cases they might occur during post space preparation. CASE REPORT: A 31-year-old female patient presented with a complaint of chronic pain on tooth #30 during last 6 months and sensitive to bite since a few days ago. There was a mild swelling on the gingival tissue in the furcation area in the intraoral examination, with a narrow strip-shaped pocket measuring 3 mm in depth. Radiographic examination revealed an incomplete root canal treatment of the tooth. A prefabricated post had been placed in the distal root, with an incorrect path toward the furcation area. There was a small radiolucency in the furcation area and a pronounced radiolucency around the mesial root of the tooth. After removal of the post, hemorrhage was observed in the furcation area. The diameter of the perforation was approximately 1 mm. The perforated area was sealed with Pro Root mineral trioxide aggregate (MTA). In the next session when setting of MTA was evaluated and confirmed, retreatment of the tooth was done. After 6 months, no swelling or sensitivity was observed and after 6 year follow-ups radiographic examination revealed that the lesion had almost resolved. CONCLUSION: In the present case, the lesion of furcation perforation was small in size, but the time interval between the occurrence of perforation and the repair procedure was long, success was achieved due to the control of the aseptic conditions, control of hemorrhage and proper placement of the repair material, which was confirmed in the 6 year follow-ups.