Perforations are iatrogenic or pathologic communications between the root canal space and the attachment apparatus. The causes of perforations are resorptive defects, caries, or iatrogenic events that occur during and after endodontic treatment. Regardless of etiology, a perforation is an invasion into the supporting structures that initially incites inflammation and loss of attachment and ultimately may compromise the prognosis of the tooth.When evaluating a perforated tooth, there are a number of factors that must be considered individually and collectively to properly guide treatment. Treating clinicians must identify the four dimensions of a perforation and understand how each of these entities critically affects treatment selection and prognosis.
In general, when a tooth is perforated, the defect should be repaired as quickly as possible to protect the periodontal attachment. From your question, I could not tell if you are dealing with an apical or midroot strip perforation. Depending on where the perforation is will determine treatment sequence. However, the material of choice to repair and seal a perforation is Mineral Trioxide Aggregate (MTA).

Blantus Endodontic Center

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