Single Visit Internal Perforation Repair Using a Novel HCSC and an Internal Isolation Technique: A Case Series

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Introduction: Communications between the root canal system and the external tooth surface are referred as perforations and are a common complication in the endodontic routine. Mineral Trioxide Aggregate is the gold standard material for perforation repair due to its characteristics such as biocompatibility and sealing ability. In recent years a lot of MTA-like products, commonly referred to as hydraulic cements or bioceramics, gained popularity as they set faster and are easier to handle compared to the classic MTA formulation. The standard perforation repair involves sealing the perforation first and then checking the setting of the material and completing the root canal treatment in a second visit. The internal isolation technique proposed in this case series is a novel, alternative method addressing the root canal treatment of a perforated tooth. Materials and Methods: Four cases are presented, each with a varying degree of perforation of the pulpal floor, all of them managed in single session treatments using the internal isolation technique. This technique involves the application of a fast setting hydraulic cement and its isolation from excessive water while completing the root canal treatment. The material thus can be allowed to sufficiently set before the end of the session, therefore allowing the finalisation of the complete therapy. Results: All the presented cases showed a positive outcome of the therapy. Discussion: The internal isolation technique appears to be a viable way to manage perforations while reducing the number of sessions required.

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