Surgical repair of root perforation caused by an orthodontic miniscrew implant

Root damage is a significant complication of orthodontic miniscrew implant placement. Although root damage is rare, its proper management should be clearly understood by practitioners. This article reports the iatrogenic root perforation of a mandibular lateral incisor caused by the placement of a miniscrew. Despite a large radiolucent area caused by chronic apical periodontitis, the perforation was successfully repaired by using a recently developed material, mineral trioxide aggregate. The treatment, clinical implications, and clinical guidelines for preventing root damage during miniscrew placement in orthodontic practice are discussed. (Am J Orthod Dentofacial Orthop 2011;139:407-11)