Diagnosis and management of endodontic perforations – report of two cases and review of the literature

Nora L. Paisner

Paisner, Nora L., Mupparapu, Mel, Dayo, Adeyinka F.
University of Pennsylvania School of Dental Medicine, Department of Oral Medicine


The aim of this article is to review the literature and report two cases involving perforations during endodontic treatment with emphasis on evidence-based diagnosis and management strategies.


We present two case reports with perforation during root canal treatment. With these case reports we highlight diagnosis and management strategies.


Endodontic perforations are common in clinical dental practice. Even with advanced technology, diagnosis and management of perforations are still challenging and good prognosis is critically dependent on early diagnosis with appropriate treatment. This review of the literature was designed to discuss the most common types of endodontic perforations and their etiology with identification of the best clinical and radiographic methods used for the detection of such perforations, along with evidence-based management strategies


Diagnosis of endodontic perforation is challenging and requires clinical and radiographic examination, preferably cone beam computed tomography (CBCT). Management of the lesion can be surgical or non-surgical, depending on the extent and location of the perforation. In both cases discussed, bioceramic (BC) putty was the material selected to seal the communication.