Delayed lateral root perforation repair with MTA, after iatrogenic post cementation in the furcation area: A long-term follow-up of two cases

Introduction: Iatrogenic root perforation is a major complication of endodontic and restorative treatments, leading to impairment of tooth prognosis. The aim of this article is to report two cases of successful non-surgical management of lateral perforation using mineral trioxide aggregate (MTA). Case report: This article presents two cases of lateral root perforation due to incorrect post space preparation and iatrogenic cementation of prefabricated posts in the furcation area. A standard disinfection protocol was utilised for the non-surgical root canal retreatment. White and grey MTA were the biomaterials of choice to seal the perforating defects. A novel technique for MTA placement and compaction was applied. The affected teeth were then referred for coronal restoration. Postoperatively, the affected teeth remained asymptomatic and functional. After an 18-month follow-up period, the radiological examination displayed favourable healing outcome and periodontal ligament regeneration in the furcation area. Conclusion: Despite the advances in the endodontic armamentarium, including the application of magnification and the availability of biomaterials, the management of root perforation remains a challenging clinical issue. Apart from effective root canal disinfection and obturation, the intracoronal application of MTA provided an effective seal upon the perforative defects, promoted biological repair and improved the prognosis in two cases of compromised, perforated teeth. Keywords: disinfection, furcation, lateral root perforation, mineral trioxide aggregate, treatment outcome