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Izvestia Journal of the Union of Scientists - Varna. Medicine and Ecology Series

Iatrogenically induced perforations of the root canal system—diagnosis, prognosis, and treatment

Vesela Radomirova, Tsvetelina Borisova-Papancheva, Slavena Svetlozarova


The purpose of the article, presenting summarized data from various and extensive literature sources, is to provide information on iatrogenically induced perforations of the root canal system, their diagnosis, timely treatment and prognosis. Root perforation is a pathological communication between the walls of the root canal and the periodontal space (the outer surface of the tooth). It usually occurs as a result of an accident during endodontic treatment or a pathological change (such as aggressive dental caries, external or internal inflammatory root resorption). Reaching the pulp chamber and the furcation area of the root, a caries can cause a perforation defect. Identification of root perforations is done through a combination of clinical and imaging exams. Cone-beam computed tomography represents an important resource for the diagnosis and prognosis of this clinical condition. The prognosis of a tooth with a root perforation depends on the time elapsed before obturation of the perforation, the location and size of the lesion, and the sealing ability of the material used. Perforation defects can be treated by non-surgical or surgical techniques and methods. A small perforation of the root immediately sealed and located apical from the alveolar bone and epithelial attachment has a better prognosis.



iatrogenic perforations, root canal system, MTA

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