Aim: To present a modified matrix concept for repair of root perforations using mineral trioxide aggregate (MTA).
Summary: Root perforations may occur during preparation of endodontic access cavities or during post-space preparation. The perforation creates the potential for an inflammatory reaction in the periodontal ligament. A concept for the repair of root perforations is presented using a matrix of resorbable collagen. This matrix reconstructs the outer shape of the root and facilitates the adaptation of MTA. The indications for the use of MTA are discussed. Two clinical cases of 5-year successful root perforation repair using the technique are presented.
Key learning points: Long-term perforations with periodontal inflammation can be successfully treated with MTA. Matrices for MTA placement can be developed with commercially available collagen. Infection control within the root canal and at the perforation site is required for satisfactory perforation repair and healing.