Perforations of the pulp chamber or root canals can occur during endodontic treatment. Larger, strip-type perforations that are supracrestal with bone loss and delayed repair have the most guarded prognosis, while small, furcal-type perforations that are subcrestal with minimal bone loss and immediate repair have the best prognosis. Many materials have been used to repair perforations, including amalgam, composites, and zinc oxide eugenol cements. However, these materials require a dry field, and they don’t promote new tissue formation. Mineral Trioxide Aggregate (MTA) has significantly improved the prognosis for perforation repair. MTA is a cement material that sets in the presence of moisture, and it has been shown histologically to support the growth of cementum, thus allowing re-establishment of the periodontal ligament. Currently, MTA is considered the material of choice for sealing perforations due to its biocompatibility, sealing ability, and hydrophilicity.
Source: Endodontics: Colleagues for Excellence, Fall/Winter 2004, American Association of Endodontists
