Biocompatible Approach to Iatrogenic Perforation: Mineral Trioxide Aggregate-based Repair in Endodontics

Iatrogenic perforations are serious problems in endodontics because they create a connection to the periodontal space, which can significantly impact treatment results and prognosis. This case report shows that Mineral Trioxide Aggregate (MTA) is an effective solution for treating iatrogenic perforations in the area of the mandibular second premolar. A 48-year-old woman was referred for treatment after an accidental perforation occurred in her right mandibular second premolar, near the alveolar crest. Radiographic and clinical assessment revealed that the perforation extended into the periodontal space. A rubber dam was used to isolate the area during the ProRoot MTA treatment for the perforation. The treatment plan included disinfection of the tooth and the concerned site of perforation, sealing of the defect with MTA, root canal treatment, followed by placement of composite restoration. Throughout the follow-up period, the patient reported no symptoms, indicating that the treatment was successful. MTA is biocompatible, has sealing properties, and promotes tissue regeneration. In the present case, early diagnosis, early management, and proper material selection were responsible for the success. This case highlights the importance of following protocols in endodontic treatment to effectively manage such complications. MTA is a reliable material for repairing root perforations, mainly in challenging clinical scenarios.