A LITERATURE REVIEW OF THE AETIOLOGY, DIAGNOSIS AND MANAGEMENT OF ROOT PERFORATIONS
Abstract
This literature review aims to bring the reader up to date with root canal perforations by discussing the aetiology, classification, diagnostic methods, treatment approaches and review of the materials for repair, prognostic factors and ways for prevention.
A comprehensive search of the literature was undertaken between August 2019 and December 2019 to search all relevant published articles from the year 2000 till 2019 related to root canal perforations by using PubMed, Cochrane library, SCOPUS and Europe PMC as well as a manual search.
Root canal perforation is one of the most complicated errors is defined as “a mechanical or pathologic communication between the root canal system and the external root surface”. The prevalence of root canal perforation ranges from 2% to 12%.
Perforation can be either iatrogenic by accidental error during the treatment or pathologic as results of resorption or caries. The key factor in root canal perforation treatment is an early diagnosis which can be made either clinically or radiographically or by CBCT. To treat root canal perforations and prevent bacterial contamination, the standard treatment is to seal the perforation site immediately with a suitable material. There are various materials used to repair root canal perforations. Mineral Trioxide Aggregate is now considered the gold standard repair material due to its biocompatibility, promotion of bone healing and cementum regeneration.
Management and prognosis of root perforations depends on early diagnosis, the location, size of the perforation and treatment timeline. There are two approaches for treatment, non-surgical or surgical approach. Non-surgical approach showed a high success rate and should be chosen whenever it is possible.
Prevention is always preferable to repair and there are several protocols that practitioners can follow to prevent perforations during each stage.