Alshehri Maram M, Alhawsawi Bushra F, Alghamdi Atheer, Aldobaikhi Salem O, Alanazi Maha H, Alahmad Fahad A
College of Dentistry, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, SAU.
Restorative Department, Riyadh Elm University, Riyadh, SAU.
Cureus. 2024 Oct 24;16(10):e72296. doi: 10.7759/cureus.72296. eCollection 2024 Oct.
Root canal perforation is defined as an opening or communication of the root to the outer oral tissue that occurs either accidentally during root canal therapy or due to unknown pathological causes, which generally result in complications in patients due to the passage of microorganisms to the surrounding tissues. These complications may necessitate extraction of the affected tooth. In this literature review, 42 articles were reviewed initially; 33 of them were included in the final analysis based on exclusion and inclusion criteria. Root perforation may occur due to caries, external and internal resorption, trauma, as well as iatrogenic causes. Many studies have suggested that perforation can be identified by radiographs, unexpected bleeding and pain during instrumentation, blood on paper points, electronic apex locator, and dental operating microscope. Several materials have been used in endodontic perforation repairs, such as indium foil, super 2-ethoxybenzoic acid (super EBA), as well as bioceramic materials like mineral trioxide aggregate (MTA) and biodentine. These materials must achieve biocompatibility, bacteriostatic ability, and radio-opacity. Many studies have reported the superior properties of MTA in comparison with other materials. Based on our literature review, management of root perforation should be performed based on multiple significant factors. Clinicians must possess a comprehensive understanding of tooth anatomy to prevent perforation occurrence. Furthermore, clinical management and prognosis of root perforation have been enhanced by the availability of advanced materials and sealing techniques.
根管穿孔的定义是，在根管治疗过程中意外发生，或由于不明病理原因导致牙根与口腔外部组织相通，这通常会因微生物进入周围组织而给患者带来并发症。这些并发症可能需要拔除患牙。在这篇文献综述中，最初检索了42篇文章；根据纳入和排除标准，最终分析纳入了其中33篇。根管穿孔可能由龋齿、内外部吸收、创伤以及医源性原因引起。许多研究表明，穿孔可通过X线片、器械操作时意外出血和疼痛、纸尖带血、电子根尖定位仪以及牙科手术显微镜来识别。几种材料已用于牙髓穿孔修复，如铟箔、超2 - 乙氧基苯甲酸（super EBA），以及生物陶瓷材料如矿物三氧化物聚合物（MTA）和生物活性玻璃陶瓷（biodentine）。这些材料必须具备生物相容性、抑菌能力和射线阻射性。许多研究报告了MTA与其他材料相比具有更优异的性能。基于我们的文献综述，根管穿孔的处理应基于多个重要因素进行。临床医生必须全面了解牙齿解剖结构以预防穿孔的发生。此外，先进材料和封闭技术的应用提高了根管穿孔的临床处理水平和预后。
