Root perforations are the communications between the periodontal apparatus of the tooth and the root canal system. Although some of them are pathologic, the majority are caused by iatrogenic events. Regardless of the etiology, a perforation is an invasion into the supporting structures that causes inflammation and loss of attachment. These in turn compromise the health of the periradicular tissues and ultimately the prognosis of the tooth. Left untreated, perforations result in the loss of integrity of the root and further destruction of the adjacent periodontal tissues. Root canal perforations can occur before, during or after an intervention. Clauder and Shin reported that a high percentage (53%) occurs as a result of prosthodontic treatment, with 47% taking place during routine endodontic treatment.
