Perforation repair with mineral trioxide aggregate: a modified matrix concept

Abstract

Long-term perforations with periodontal inflammation can be successfully treated with MTA. Matrices for MTA placement can be developed with commercially available collagen. Infection control within the root canal and at the perforation site is required for satisfactory perforation repair and healing.

Comparing Gray and White Mineral Trioxide Aggregate as a Repair Material for Furcation Perforation: An in Vitro Dye Extraction Study

“…In contrast to other treatment concepts, this technique uses collagen as a completely resorbable barrier material and MTA for sealing of the perforation. This not only results in repair of the defect, but also promotes healing of the periodontal ligament as shown by the cases [3].…”

“…However, it had several drawbacks -(a) Molecular size of the dye molecules is smaller than bacteria, (b) It does not measure the actual volume absorbed by sample but merely measures the deepest point reached by the dye. (c) It relies on randomly cutting the roots into two pieces, without any clue of the position of the deepest dye penetration [3]. Torabinejad et al, stated that a material that is able to prevent the penetration of small molecules should be able to prevent larger substances like bacteria and their byproducts [12].…”

“…Based on this, the dye extraction method seems to be a reliable technique. It takes into account all absorbed dye by the samples [3].…”

“…The perforations can occur due to caries, resorption, or iatrogenic factors like during access cavities, coronal shaping and post space preparation [3]. Regardless of the cause, furcation perforation is followed by bacterial contamination, periodontal fiber destruction, periradicular tissue injury, inflammation, bone resorption [2].…”

Apexification of Immature Teeth Using Novel Apical Matrices and MTA Barrier: Report of Two Cases

“…The use of a matrix is advisable since its placement in the area of bone destruction provides a base on which the sealing material, especially MTA, can be placed and packed in the perforation [10][11][12][13] Several materials have been recommended to create a matrix, in cases of perforations as well as teeth with incomplete formation of apex; including calcium hydroxide, hydroxyapatite, resorbable collagen and calcium sulfate [11][12][13][14][15][16]. Materials such as Platelet rich fibrin (PRF), DFDBA (dimeralised freeze dried bone allograft) are widely used as graft material in periodontal and oral surgical procedures but not reported in literature to be used as apical matrix.…”