Endodontic perforations

Perforation is defined as the mechanical or pathological communication between the root canal system and the external tooth surface. It is one of the endodontic complications during root canal treatment. It may occur during any stage of the treatment, access cavity, cleaning and shaping, or as a result of internal resorption that is extended to the periapical tissues. Eventually, chronic inflammation will occur in the periodontium, which is characterized by the formation of granulation tissue and loss of bone attachment around the perforation. Cone-beam computed tomography constitutes an important resource for the diagnosis and prognosis of clinical conditions. Two modalities are available for the management of these perforations, either surgical or nonsurgical approaches. Many materials have been used for the treatment of root canal perforation such as amalgam, Super EBA, and glass ionomer, but recently mineral trioxide aggregate (MTA), and bioceramic putty showed better results and outcome.