Nonsurgical Management of Simultaneous Double Lateral Root Perforations in Adjacent Teeth Using CBCT and MTA: A Case Report

TL;DR

A nonsurgical method using CBCT and MTA successfully repaired two lateral root perforations in adjacent teeth, leading to full healing.

Contribution

This case demonstrates a successful nonsurgical approach using CBCT and MTA for treating simultaneous lateral root perforations.

Findings

CBCT confirmed lateral root perforations not visible on periapical radiographs.

MTA-based repair led to asymptomatic teeth and radiographic healing after one year.

Nonsurgical treatment with CBCT guidance is a viable solution for complex root perforations.

Abstract

Lateral root perforations are serious iatrogenic complications that can compromise the outcome of endodontic treatment. The current case report presents the successful treatment of simultaneous double lateral root perforations in the mandibular canine and first premolar using a nonsurgical approach guided by cone beam computed tomography (CBCT) and mineral trioxide aggregate (MTA). Perforations that were not detectable with periapical radiographs were confirmed using CBCT, and the treatment planning was performed based on the millimetric measurements provided by CBCT. The treatment protocol included rubber dam isolation, microscopic assistance, effective irrigation, calcium hydroxide intracanal medication, and definitive sealing of the perforation sites with MTA. The 1-year follow-up revealed asymptomatic teeth with normal function and radiographic evidence of periapical healing. This case highlights that CBCT-guided MTA repair provides a predictable, minimally invasive solution for managing iatrogenic lateral root perforations, though its success is contingent upon a meticulous approach and regular follow-up.

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