Application of the MTA in the management of pulpal floor perforation – a case report

Pulpal floor perforation, defined as the communication between the canal system and the root’s external surface, is one of the complications in endodontic treatment. Lack of sufficient closure of the perforation may result in the failure of the treatment. A material dedicated for the closure of the perforation is the MTA (Mineral Trioxide Aggregate) cement. The study presented herein shows a case of an old pulpal floor perforation in the lower left second molar (tooth 37), co-existing with the damage to the periodontal tissues, omitted mesiolingual canal and the inflammation in the periapical area. An initial cone beam computed tomography analysis helped to plan the retreatment and determine the prognosis. Written consent from the Patient was obtained. The endodontic retreatment, including the disinfection and closure of the perforation with the MTA, was successful. The control radiographs and clinical assessments after 4 months and 3 years showed complete regeneration of inflammatory lesions and new bone structure in the furcal area. The MTA cement is effective in closing old pulpal floor perforations and allows for the regeneration of the lost bone in the furcal area.