THE CASE FILES CASE 009 — MANDIBULAR MOLAR

Sealing the wrong turn.

A drill searching for a canal went 2mm past where it should have — straight into the furcation. Three hours later the hole was sealed, and three years later the tooth is still here.

MISHAPS ✦✦ CHALLENGING 2 APPOINTMENTS
Final radiograph — completed obturation with MTA repair in place
Pre-op CBCT showing furcation perforation with radiolucency
BEFORE AFTER
◂▸
Sealing the wrong turn
CASE 009 — MISHAPS · TORRANCE
THE PLATES — FULL SEQUENCE
THE CASE

One tooth's journey, in four beats.

01
THE PROBLEM

The call every dentist dreads.

Searching for a distal canal, the referring dentist drilled slightly too far and perforated into the furcation of a 68-year-old Carson patient's molar. He did exactly the right thing: stopped immediately and called.

02
THE PICTURE

A race against contamination.

Every hour a perforation stays open, bacteria colonize the defect and the odds fall. Seen within three hours — inside the window where repair succeeds about 90% of the time.

03
THE WORK

A seal in the dark.

Bleeding controlled with calcium chloride, the 2mm defect isolated under the microscope, and MTA — biocompatible, antibacterial, moisture-tolerant — packed into the perforation.

04
THE RETURN

Finished properly.

After the MTA set, the root canal was completed over the repair. Three years on: normal probing depths, bone maintained, no symptoms — a functioning tooth instead of an implant.

THE PROTOCOL
  •   Hemostasis first — calcium chloride pellets to control the bleeding
  •   Dry field established under the microscope; defect isolated
  •   MTA packed into the 2mm furcation perforation at high magnification
  •   48–72 hours for the MTA to fully set
  •   Second visit — root canal treatment completed over the sealed repair
  •   Recalls: normal probing depths, bone maintained at 3 years
WHAT THIS CASE TEACHES

What this case teaches.

TIMING Hours decide the outcome Repaired same-day, perforations succeed about 90% of the time; after a month, the odds drop by half. This one was sealed within three hours.
CANDOR A complication, not a catastrophe Perforations happen to good dentists. The referring dentist's decision to stop and call immediately is what saved this tooth.
MATERIAL MTA is the gold standard Biocompatible, antibacterial, sets even in moisture, and seals hermetically — the reason a hole in a tooth can heal.
CLINICAL DISCLAIMER: PRESENTED FOR EDUCATIONAL PURPOSES WITH PATIENT CONSENT. IDENTIFYING INFORMATION REMOVED PER HIPAA. INDIVIDUAL RESULTS VARY. ALL IMAGES REPRESENT ACTUAL PATIENT TREATMENT.
MORE FROM RETREATMENT & REPAIR
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  • Scheduled for extraction, still here — Another provider said the tooth had to go — a perforation, a draining sinus tract, a root canal that had failed. Five years after combined retreatment and surgical repair, it's still doing its job.
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