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Endodontic Healing with Perforation Repair

Posted Aug 26 2008 1:07pm

This patient came to my office in March of 2003. She had two large "all porcelain" bridges done a year and a half earlier between #22-#27. Teeth #24 & #25 were diagnosed as necrotic with Chronic Apical Periodontitis. Endodontic therapy was initiated.

To my dismay, a suprabony perforation was created on the distal of #24.

After a little redirection, the canals were located and then instrumented and obturated.

Both teeth were obturated with gutta percha. Because the perforation was suprabony, Geristore was selected as the repair material. Since geristore is a resin, it will not wash out, making it ideal for a defect above the level of crestal bone. The patient was informed of the perforation defect and its repair.

Typically I would re-evaluate this case 6 months to a year following completion. This patient chose not to return until another tooth needed endodontic treatment.

The patient reported no symptoms and our recall film at 3 yrs 9 months shows complete healing of the apical radiolucencies.

Retaining these teeth with endodontic therapy allows for healing of the bone and maintains the crestal level of the bone as well as provides more life from the recently placed porcelain bridges.

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