PMC3099123_01
Perforation site in disto-lateral mid-root area of tooth 11 under Microscope in 16X magnification
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F1
Dental Operating Microscope (FS - 1-11; MOELLER - WEDDEL INTERNATIONAL, Germany) (16X Magnification). Distolateral midroot perforation with ledge formation was clearly visualized under the microscope [Figure 1].
IOPA radiograph of tooth 11 with GP point placed through the perforation
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F2
An intraoral periapical radiograph was taken with a #60 size gutta percha (GP) point placed in the perforation, which aided in further localizing the site of the perforation, and it was confirmed that the defect was subcrestal [Figure 2].
GP point placed in the canal
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F3
Working length was established and a #40 size GP point was placed in the canal [Figure 3].
Piece of Healiguide resorbable collagen matrix carried out into the access cavity
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F4
Pieces of healiguide were appropriately cut and carried out into the access cavity [Figure 4].
Collagen matrix placed corresponding to the cavosurface of the root
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F5
A solid barrier was established [Figure 5].
After 48 hours well adapted hard MTA visible under 24X magnification - completely filled the perforation defect
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F6
Trioxide Aggregate, and closed with noneugenol temporary restoration (Cavit, 3MESPE). The Mineral Trioxide Aggregate was allowed to set for approximately four hours and the patient was recalled after four hours. The canal was opened and it was found that the well-adapted, hard Mineral Trioxide Aggregate had sealed the perforation site and ledge area [Figure 6].
Obturation done in tooth 11
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F7
Apical preparation was performed up to size #60 and obturation was done by lateral condensation of the gutta percha [Figure 7].
Light Cure Composite build up done in tooth 11
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F8
The crown was restored by a light cure composite resin [Figure 8].
1 year postoperative radiograph of tooth 11
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F9
A radiographic analysis at this recall evaluation revealed no development of a periapical lesion and no further widening of the PDL [Figure 9].