Treatment Outcome after Repair of Root Perforations with Mineral Trioxide Aggregate: A Retrospective Evaluation of 90 Teeth

Introduction: In this retrospective study, the success rate for the repair of root perforations using mineral trioxide aggregate was investigated. Methods: One hundred forty consecutive cases of teeth with perforations were included in the sample; 128 finally met the inclusion criteria. All treatments were performed between 1999 and 2009 in a dental office limited to endodontics. Perforations were sealed with mineral trioxide aggregate using a dental operating microscope. Treatment success was assessed by analyzing clinical data and radiographs 1-10 years after treatment. The radiographs were evaluated by 2 independent calibrated examiners. The outcome measure was dichotomized as "healed" or "failure." The relationship between preoperative data and treatment outcome was examined to determine potential prognostic factors. Results: From 128 teeth, 90 were accessible for recall (70.3%). The mean follow-up interval was 3.4 years. Sixty-six teeth (73.3%) were classified as healed. A significant relationship between treatment success and the presence of a preoperative lesion at the perforation site was found. Those teeth in which a lesion at the perforation site was present before treatment showed a lower healing rate. Teeth with a preoperative communication between the perforation and the oral cavity showed the lowest success rate. Conclusions: Two prognostic factors for healing of teeth with perforations were, identified. The presence of a preoperative lesion at the perforation site and direct contact between the perforation and the oral cavity were related to lower treatment success rates.