A Heroic Repair with MTA
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Claudia Hoffman, D.D.S.
A Heroic Repair with MTA
Claudia Hoffman
http://www.endomail.com/articles/ch17heroic.html[5/26/2011 11:18:03 AM]
www.Tekscan.com/Den
Colgate.co.in
www.drravikumar.in
TWENTY-FIVE-YEAR-OLD female
presented to our office with a history of
root canal therapy, installation of a post
and core, and a temporary crown three months
prior to her visit. The patient had unremarkable
medical and dental history. Her chief complaint
was, “I had a root canal and ever since my tooth
has hurt. First it swelled up and now it just aches
all the time. I was told I need a root
amputation.”
The initial radiograph revealed that # 30 had
undergone root canal therapy that appeared good,
but there was bone loss in the furcation. (See
Figure 1.) The intra-oral exam revealed pain in
response to percussion, palpation, and chewing.
The patient was advised that # 30 was losing
bone in the furcation and was possibly cracked FIGURE 1: Showing root canal therapy
or perforated. The treatment options were on # 30 with bone loss in the furcation.
presented to the patient: extraction and an
implant or bridge or exploration and possible
repair if at all possible.
The patient chose to have me try to find the
etiology of the problem and try to repair the
problem if possible. She was advised that the
prognosis for any treatment to try to save the
tooth at this time was very guarded.
The tooth was isolated under a rubber dam and
the core filling was removed. A large round
perforation was apparent on the mesial-buccal
area, and there was tremendous bleeding and
destruction of the bone. The perforation was
cleaned and irrigated with sodium hypochlorite,
EDTA, and chlorohexidine. Then the repair was
sealed with MTA. This material was chosen
because it exhibits excellent tissue compatibility
A Heroic Repair with MTA

and creates a non-resorbable barrier. Also, it FIGURE 2: Showing the repair sealed
was very difficult to obtain homeostasis and with MTA.
visibility, MTA is the material of choice in areas
with potential moisture and difficult visibility.
(See Figure 2.) The procedure was performed six
weeks ago; the patient was sore for two days and
then felt fine.
This perforation has a very guarded
prognosis. Perforations in the furcation threaten
sulcular attachment, and in this case has been
compromised. The more apical the perforation
the more favorable the prognosis. Also, the
perforation had three weeks from perforation to
repair and was large in size; these factors make
the prognosis in this case very guarded. It was a
heroic case that I thought I would share. I will
keep you posted on long-term results.

September - October 2007

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© Copyright 2007 by Musikant, Deutsch, Kase, Dukoff, Bui, Lipner, & Kim. All rights reserved.

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