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Chances of survival after mta specification and sealing of roots

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"mineral trioxide aggregate" AND endodontics

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MTA root perforation repair survival rate systematic review endodontic

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"root perforation" AND MTA

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"root perforation" AND MTA

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https://pubmed.ncbi.nlm.nih.gov/27347231

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PMID: 20113776

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PMID: 35714727

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PMID: 17508680

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Gorni Ionescu Ambrogi 2022 Prognostic Factors Primary Healing Root Perforation MTA 14-year results success percentage

MTA repair plus good root-canal sealing can give a reasonable chance of keeping a tooth, but the outcome depends much more on the size and site of the perforation, periodontal attachment/bone loss, infection control, and whether the tooth can be properly restored than on MTA alone.
For root perforations repaired with MTA:
  • A clinical study found 18 of 21 teeth healed, about 86%, at a median 33-month review. Mente et al., 2010
  • A larger long-term cohort reported 93% initial healing within the first one to two annual reviews. However, some initially healed cases developed recurrent problems with time. Estimated recurrence was 6% at 5 years, 30% at 10 years, and 62% at 14 years in that cohort. Higher risk was associated with a perforation larger than 3 mm and a positive periodontal probing defect. Gorni et al., 2022
  • MTA is a well-supported repair material because it seals well and is biocompatible. The best prognosis is when the defect is repaired promptly and contamination is controlled. Review of MTA perforation repair
For your scan: this is a photograph of a CBCT screen, not enough to reliably measure the defect or judge root fracture, remaining dentine, and periodontal communication. I can see a lower molar region with a substantial area of bone change around the roots, but I cannot diagnose the precise cause or predict survival from this single screen image.
A practical estimate is:
  • Favourable case: small, accessible perforation; no vertical root fracture; no deep isolated gum pocket; infection cleaned; good crown/seal afterward. Often roughly 80% to 90% short-to-medium term healing/retention is realistic from the reported studies.
  • Guarded case: large defect, furcation or strip perforation with bone loss, persistent sinus tract, deep probing, delayed repair, crack/fracture, or inability to place a durable crown. Prognosis can fall substantially and extraction may ultimately be needed.
Ask your endodontist these specific questions:
  1. Is there any sign of a vertical root fracture?
  2. What is the perforation size and exact location: furcation, lateral root, or apical?
  3. Is there a deep isolated periodontal probing defect communicating with the perforation?
  4. Is sufficient healthy tooth structure left for a crown with a ferrule?
  5. What is the baseline CBCT finding, and will you review clinically and radiographically at 6 to 12 months, then periodically?
The first meaningful sign of success is usually no pain/swelling and progressive bone healing over 6 to 12 months, not an immediate normal-looking scan.
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