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Spontaneous repair of iatrogenic root perforation by an orthodontic miniscrew: A case report

Authors
 Pi-En Chang  ;  Euiseong Kim  ;  Woowon Jang  ;  Hye Young Cho  ;  Yoon Jeong Choi 
Citation
 JOURNAL OF THE AMERICAN DENTAL ASSOCIATION, Vol.152(3) : 234-239, 2021-03 
Journal Title
 JOURNAL OF THE AMERICAN DENTAL ASSOCIATION 
ISSN
 0002-8177 
Issue Date
2021-03
Keywords
Tooth injuries ; implants ; orthodontic appliances
Abstract
Background and overview: Orthodontic miniscrews have become popular tools for providing temporary anchorage during orthodontic treatment. Although they are easy to insert, damage to the periodontal ligament or dental root during insertion is an unfavorable iatrogenic complication. Root perforation during miniscrew insertion in human teeth has been reported in a few articles. In this article, the authors describe the spontaneous repair of an iatrogenic root perforation in a mandibular first molar that occurred during insertion of an orthodontic miniscrew in a young girl undergoing orthodontic treatment. Case description: A 15-year-old girl with malocclusion was undergoing orthodontic treatment when the mesial root of her mandibular right first molar was damaged by an orthodontic miniscrew. The miniscrew and corresponding bracket were immediately removed to avoid any unnecessary forces on the tooth. Because the pulp remained vital without any additional damage and infection for 6 months, orthodontic treatment was resumed and completed in 9 months without any pulp damage or unfavorable symptoms. Serial periapical radiographs and cone-beam computed tomographic images showed that the injured area was surrounded by reparative tissue without any apical lesion. Conclusions and practical implications: The findings of this case suggest that immediate removal of unnecessary forces provides an environment for spontaneous repair in cases of iatrogenic root perforation by orthodontic miniscrews, even when the damage involves the pulp. If force stimulation is avoided for a certain period, which was 6 months in this case, it may be possible to complete the orthodontic treatment without unfavorable symptoms.
Full Text
https://www.sciencedirect.com/science/article/pii/S0002817720306383
DOI
10.1016/j.adaj.2020.08.022
Appears in Collections:
2. College of Dentistry (치과대학) > Dept. of Conservative Dentistry (보존과학교실) > 1. Journal Papers
2. College of Dentistry (치과대학) > Dept. of Orthodontics (교정과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Eui Seong(김의성) ORCID logo https://orcid.org/0000-0003-2126-4761
Choi, Yoon Jeong(최윤정) ORCID logo https://orcid.org/0000-0003-0781-8836
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/182234
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