Table 1: Studies that investigating Sealing ability of MTA used to repair different types perforations of permanent teeth.

First author + year Description of study Type of Perforation/Case Methods of assessment Results
Menezes et al., (2005)  [30] Case report
Presents repair of a supracrestal root perforation using MTA.
32 years old patient with accidental supracrestal root perforation and radiolucent periapical area. -Clinical  examination
-Radiological examination.
After Fifteen months radiographs showed adequate sealing of supracrestal perforation and reparation of the radiolucent periapical area.
Silveira et al., (2008)   [34]. Case report
Use MTA to repair furcal perforation of different causes.
-27 years old patient with pulpal necrosis with acute periradicular periodontitis and carious furcation perforation.
- 30 years old patient with accidental furcal perforation.
-Clinical examination.
-Radiologic examination.
In the 1st case: Three months after treatment there was radiographic evidence of bone formation adjacent to MTA. In the 2nd case the final radiograph obtained at the time of treatment showed evidence of perforation seal and at 6-months follow up, bone formation was evident.
MTA was suitable material for furcation perforation repair either accidental or due to caries.
 Amaral et al., (2009)  [35] Case report
Use  MTA as a filling material in internal root resorption.
40 years old patient with an extensive destruction in the middle third of the root due to trauma at 22 year before.
52 years old patient with asymptomatic large internal resorption communicating with periodontal ligament.
-Clinical examination.
-Radiologic examination.
MTA used to treat internal root resorption was successful with 2 years follow up showed lack of pain, fistula, normal space on the periodontal ligament, no mobility, favorable periapical tissue response, with new formation of cemental coverage over MTA.
  Mehta et al., (2011)  [36] Case report
Use non-surgical approach to treat root perforation and resorption.
Male patient with lateral root perforation, widening of the periodontal ligament space and periapical abscess followed by external root resorption .
-Clinical examination -Radiologic examination.
-Non-surgical endodontic approach.
On follow up after 12 months, MTA placed to restore the osseous defect using MAP system showed no evident radicular lesion.
MTA provided an effective seal of root perforations and external resorption.
Saha et al., (2011)  [25] Case report 
repair furcal perforation with MTA.
45y Male patient with perforation in the furcation area 
18y Girl patient with perforation on the floor of the pulp chamber.
Clinical examination.
Radiologic examination.
Microscopic examination.
After 6 months follow up teeth were asymptomatic. MTA is a suitable material for closing the communication between the pulp chamber and the underlying periodontal tissues.
 Silva et al., (2012)  [26]  Case report
Repair  of iatrogenic perforation with MTA under operating microscope.
43y old female patient with coronary perforation during endodontic retreatment. -Clinical examination.
-Radiologic examination.
-Microscopic examination.
Retreatment done under operating microscope with MTA was suitable material for Perforation repair and the one year follow up with the absence of peri­radicular radiolucent lesions, pain, and swelling along with functional tooth stability showed good prognosis.
Nunes et al., (2012)  [40]  Case report
use MTA to treat a perforating internal root resorption.
32y old female patient traumatized Maxillary lateral incisor with internal radiolucent area in the middle third of the root. Clinical examination.
Surgical microscope.
Radiologic examination.
Computerized tomography.
In follow up after 11y and 8months, no symptoms, no sinus tract, periodontal bone repair with normal ossification of internal bone septa adjacent to the tooth root.
MTA was most commonly used  because of its sealing ability, biocompatibility and potential induction of osteogenesis and cementogenesis.
Upadhyay et al., (2012)  [39] Case report
Repair of perforated internal resorption using MTA.
36y female with radiolucent lesion in the internal root canal dentine walls of  maxillary incisor.  Clinical examination.
radiologic examination.
The results were satisfactory at 2-yearfollow-up.MTA resulted in rapid resolution of symptoms and signs and successful repair of perforating internal resorption.
Vijetha et al., (2012)  [32] Case report
Manage  the external cervical resorption using mineral trioxide aggregate.
Male patient external cervical inflammatory resorption with periapical lesion underwent orthodontic treatment.
Clinical examination.
Radiologic examination.
Root canal therapy.
The 1year follow up showed patient’s tooth was asymptomatic and there was no evidence of progression of the resorptive process.
Froughreyhani et al., (2013)  [29] Case report
Introduced repair of strip root perforation using MTA.
25y female patient with stripping perforation of the mesiolingual canal of mandibular 1st molar. With pain on percussion. - Clinical examination.
- Canal instrumentation.
- Radiologic examination.
On 15 month recall no signs or symptoms, and complete resolution of furcal and periapical radiolucency.
Successful repair of strip root perforation using root MTA.
Sinkar et al., (2015) [42] An ultraviolet spectrophotometric analysis.
Comparison of sealing ability of ProRoot MTA, RetroMTA, and Biodentine as furcation repair materials.
35 extracted intact human mandibular molars with non –fused well developed roots with furcation perforations. Dye extraction method. MTA has numerous clinical problems such as difficult handling characteristics, prolonged setting time, and prospective discoloration.

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