Sealing of root perforation associated with connective tissue graft in aesthetic area: Case report

Paulo Otávio Carmo SOUZA, Marina César MACHADO, Mateus Gehrke BARBOSA, Juliano Gonçalves MIGUEL, Vinícius Caixeta SOUSA, Daniel de Almeida DECURCIO, Carlos ESTRELA

Introduction: Root perforation is the communication between the walls of the root canal and the periodontal space. The time, location and size of the perforation are factors that affect the prognosis of the tooth. Objective: To report a clinical case of treatment of supraosseous root perforation associated with grafting of connective tissue in aesthetic area. Case report: Patient reported that 3 months had started root canal treatment of tooth 22, but was not finalized. At the clinical examination, the tooth presented absence of pain and presence of sinus tract in the region of attached gingiva. Radiographic and tomographic images revealed an image suggestive of root perforation in the buccal region of tooth 22, as well as a hypodense / radiolucent area circumscribed to the root apex, leading to the diagnosis of asymptomatic apical periodontitis associated with supraosseous root perforation. Initially, it were performed root canal preparation and intracanal medication. After 21 days, root canal obturation and composite restoration were performed on the palatal face. In the same session, the surgical access was made to sealing the perforation with composite resin, associated to the grafting of connective tissue in tooth 22, to avoid marginal tissue recession. It was observed after 12 months new bone formation in the periapical region of tooth 22, with absence of pain and preservation of aesthetics in the periodontal region. Conclusion: Multidisciplinary diagnosis and planning are important factors in the treatment of root perforations, as well as the correct selection of materials used to seal root perforations.

Keywords: Endodontics. Iatrogenic Disease. Graft Survival.

How to cite: Souza POC, Machado MC, Barbosa MG, Miguel JG, Sousa VC, Decurcio DA, Estrela C. Sealing of root perforation associated with connective tissue graft in aesthetic area: Case report. Dental Press Endod. 2021 Sept-Dec;11(3):75-82.

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