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

Pi En Chang, Euiseong Kim, Woowon Jang, Hye Young Cho, Yoon Jeong Choi

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)


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.

Original languageEnglish
Pages (from-to)234-239
Number of pages6
JournalJournal of the American Dental Association
Issue number3
Publication statusPublished - 2021 Mar

Bibliographical note

Funding Information:
This study was supported by grant NRF-2017R1C1B5017498 from the National Research Foundation of Korea funded by the Korea government.

Publisher Copyright:
© 2021 American Dental Association

All Science Journal Classification (ASJC) codes

  • Dentistry(all)


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