Abstract
Introduction: Calcium hydroxide exhibits bactericidal effects and hard tissue formation capabilities. However, if the sources of infection remain beyond the bactericidal effect, hard tissue formation will not occur. Perforation makes it difficult to remove the sources of infection, leading to tooth loss due to embrittlement. Reports indicate that the success rate of perforation treatment has increased with the use of dental microscopes and bioceramics. However, if the source of infection remains, sufficient healing may not be achieved even with the use of bioceramics. Therefore, we applied a calcium hydroxide preparation to the perforation site and evaluated the infection status from alveolar bone radiolucency. Good results were obtained. We report this case with a literature review. Case: A 64-year-old female presented in 2012 with pain in the mandibular left first molar. Diffuse radiolucency was observed at the distal root apex on X-ray. Radiolucency was also observed directly below the root bifurcation. She was diagnosed with pulp chamber floor perforation and acute periapical abscess. Root canal treatment and perforation treatment were performed. A calcium hydroxide preparation was applied to the perforation site. After two months, improvement in the radiolucency directly below the root bifurcation was confirmed. Hard tissue formation was confirmed at the perforation site, and it was sealed with an adhesive material. The patient has remained asymptomatic with stable clinical findings for over 10 years.
