Iatrogenic apical root perforation performed during retreatment of a mandibular central incisor: A ive-year follow-up case study

Ricardo MACHADO, Eduardo Donato Eing Engelke Back, Grazielle Reis Rafael Stiz Luiz Fernando Tomazinjo, Jacy Simi Júnior, Luiz Pascoal Vasan

Introduction: Iatrogenic root perforations occur in approximately 2% to 12% of cases involving inaccurate root canal access, attempt to locate canal orifices, instrumentation or reinstrumentation and bypassing or removal of fractured instruments. When these perforations are performed in the apical thirds, they may even lead to tooth loss due to the greater complexity of treatment. Objective: The aim of this paper was to report the occurrence of an iatrogenic apical root perforation during retreatment of a mandibular central incisor. Methods: Based on clinical and radiographic examinations, a mandibular right central incisor was diagnosed with pulp necrosis and asymptomatic apical periodontitis. Nonsurgical endodontic therapy was recommended. The final radiographic examination revealed poor endodontic treatment; for this reason, nonsurgical reintervention was the therapy of choice. The final radiograph showed apical perforation due to deviation near the apical limit. It was therefore decided that the case should be merely monitored. Results: Clinical and radiographic followups after 5 years showed the successful outcome of this decision. Conclusion: In clinical situations similar to what is shown in this case report, making the correct clinical decision, considering the characteristics of each case, is more important to long-term success than effective action.

Keywords: Root canal therapy. Retreatment. Periapical diseases.

How to cite: Machado R, Back EDEE, Reis G, Stiz R, Tomazinho LF, Simi Júnior J, Vansan LP. Iatrogenic apical root perforation performed during retreatment of a mandibular central incisor: A ive-year follow-up case study. Dental Press Endod. 2014 Sept-Dec;4(3):53-6. DOI: http://dx.doi.org/10.14436/2178-3713.4.3.053-056.oar

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