Evaluation von Perforationsdeckungen in endodontologischen Fachpraxen - eine retrospektive Multicenter-Studie

Background and aim: Endodontic treatment represents a major part of restorative dentistry. New materials and techniques shifted the borders of conservative dentistry. The use of the dental operating microscope for example allows endodontic treatment in difficult situations. Root perforation during the detection of root canals, root canal instrumentation, post preparation, or due to root resorption represents one of the most challenging situations in endodontic therapy which frequently leads to extraction. The aim of the present study is the retrospective investigation of teeth with present root perforations which were treated by endodontic specialists. Evaluation of the data included clinical and radiographic parameters that have a potential influence on the success of endodontic treatment. Materials and methods: Perforations that were treated by Dr. Oliver Pontius, Dr. Terrell Pannkuk, Dr. Marga Ree, Dr. Sashi Nallapati, Dr. Raphael Bellamy, Dr. Francesco Maggiore were included in the present study. Between January 1998 and March 2010 a total number of 74 perforations in 69 patients (70 teeth respectively) were treated endodontically or in a combined endodontic-microsurgical approach. The treatments were performed exclusively by certified endodontic specialists using the dental operating microscope. Two calibrated observers evaluated the clinical and radiographic results after 6 to 116 months (mean: 41 months, recall rate: 71,02 %). Pre-, intra- und post-op data were investigated with respect to possible prognostic factors. Results: 90 % of 54 perforations in 50 teeth were classified as healed. Regarding the investigated prognostic factors only the preoparative radiographic status had an effect on the endodontic success. However, the success rate of the present study was higher compared to other studies. Conclusions: A perforation is not necessarily an indication for the extraction of the concerning tooth and can be treated successfully by endodontic specialists if equipment and patients’ compliance are adequate. Certain prognostic factors, such as the periodontal situation, have to be evaluated and discussed with the patient prior to the decision in favour or against tooth preservation.