Improved single visit management of old infected iatrogenic root perforations using Biodentine®

Aim: The aim of this retrospective observational case series study was to evaluate the middle term outcomes on endodontic management of old infected iatrogenic root perforations using Biodentine. The treatments were always concluded in a single visit, without previous medication with calcium hydroxide. Our goal was to facilitate this kind of treatments and to make them more reproducible and manageable even for a general practitioner or a student. Methodology and methods: Between January 2011 and June 2016, 51 patients with old infected root perforations have been enrolled. All the treatments were performed using Biodentine in a single visit. Infected root perforation repair was performed by supervised dental students (39%) or a qualified endodontist (61%), employing surgical microscope magnification during treatments. After the treatment, the 51 patients were monitored for 18—64 months. We used clinical and radiographic examinations. Results: Of 51 examined teeth, 48 (94%) were classified as healed. The time, the size and the location of the perforations did not have a significant effect on the outcome. We proved the ineffectiveness of the null hypothesis. According to this latter, the single visit treatment of old infected perforations with Biodentine was inadequate. Conclusions: In single visit treatments, Biodentine seems to provide a biocompatible and effective seal in acidic environment, in accidental root perforations, even if the treatment is performed by an inexperienced operator and regardless of the location, the size and the time of occurrence of the perforation.