MTA ABILITY IN THE REPAIR OF LATERAL PERFORATIONS AND RETROGRADE OBTURATION

Resumo

Introduction: Root perforations may occur during endodontic treatment or canal preparation for intraradicular retainers, resulting in communication between the pulp cavity and adjacent tissues. Prognosis depends on factors such as perforation location, sealing ability, and the physical and chemical properties of the repair material. Mineral trioxide aggregate (MTA) has been widely used in the management of root perforations and retrograde fillings due to its favorable biological and physicochemical properties. Objective: To report a clinical case of lateral root perforation and retrograde obturation of a mandibular premolar surgically treated with MTA, aiming to preserve an existing fixed prosthesis, and to discuss the outcome based on the literature. Methodology: A 49-year-old female patient presented with a recurrent fistula associated with a mandibular premolar rehabilitated with a fixed prosthesis. Radiographic examination revealed a lateral root perforation and a periapical lesion. Due to the high risk of fracture associated with post removal, paraendodontic surgery was performed, including lesion enucleation, sealing of the lateral perforation, apicectomy, ultrasonic retropreparation, and retrograde obturation with MTA. Histopathological analysis and clinical and radiographic follow up for 24 months were conducted. Results: Histopathological findings confirmed a periradicular granuloma. Follow-up demonstrated satisfactory healing, bone neoformation, and absence of clinical or radiographic signs of recurrence. Conclusion: Surgical repair of lateral root perforation and retrograde canal obturation using MTA promoted adequate tissue repair without removal of the existing prosthesis, representing a viable therapeutic alternative in selected cases.

Keywords: Retrograde obturation. Trepanation. Mineral trioxide aggregate (MTA).