Surgical treatment of a root perforation with simultaneous filling of root canal – case report

Vol. 11 – Number 41 – 2019 CLINICAL DENTISTRY NOTEBOOK Case report Page 119-126 Surgical treatment of a root perforation with simultaneous filling of root canal – case report Arthur Costa Lemos¹ Murilo Priori Alcalde² Francine Cesario³ Rodrigo Ricci Vivan² Marco Antônio Húngaro Duarte4 Abstract The insucess of the endodontic treatment is described as the persistence of clinical and radiographic signs and painful symptomatology post-treatment. Its therapy (non-surgical and surgical treatment) and prognosis depend on the cause and tooth conditions. The aim of this study was report a case of an endodontic treatment failure associated with a root perforation retreating its etiology, diagnosis, management, and overcome. A 32-years old male patient was reffered to clinic of endodontics in Bauru School of Dentistry with complaint of discomfort in the region of maxillary right lateral incisor for evaluation. The radiographic revealed the presence of periapical lesion and unsatisfactory filling, while the clinical examination revealed the presence of periodontal pocket, discrete mobility, sensitivity to vertical percussion and to apical palpation. The tomographic examination showed a perforation on vestibular region of the root associated with filling material extravasation suggesting it be the cause of the failure of the primary endodontic treatment. The surgery was indicated as intervention. The perforation was surgically exhibited, cleaned up, and sealed with SuperEBA, while the root canal was simultaneously retreated and filled. Finally, a bone grafting and a membrane insertion were performed to induce tissue regeneration of the region. Four years follow up x-ray and clinical exam showed satisfactory repair of the hard tissue with absence of painful symptomatology. The correctly diagnosis and the surgical treatment with simultaneous filling of root canal were determinant for satisfactory repair of periapical lesion and the resolution of inflammation signs and symptomatology. Descriptors: Root perforation, apical surgery, simultaneous filling. ¹ Master’s student in Endodontics – FOB / USP. ² Prof. in Endodontics – FOB / USP. ³ PhD student in Endodontics – FOB / USP. 4 Prof. Head of Endodontics – FOB / USP.