Perforation is one of iatrogenic factors responsible for endodontic failure. Root canal perforation can occur at the cervical, mid-root, or apical levels. Non-surgical (conservative) perforation repair offers less tissue destruction and easy isolation during treatment. Objective: To explain the management of apical third root perforation using the conservative technique. Case Report: This case report describes a 29-year-old patient who came for management of right maxillary lateral incisor with apical third root perforation on the labial aspect. The location of apical third root perforation was evaluated using cone beam computed tomography (CBCT). Root perforation was sealed using mineral trioxide aggregate (MTA). MTA was applied in conservative technique with hand filling. MTA was dispensed into the original canal while maintaining the patency of the perforated canal, followed by dispensed of MTA into the perforated canal. Conclusion: Root perforation should be identified as soon as possible and could be easily examined using CBCT. Non-surgical root perforation treatment is recommended in intact periodontal attachment and in absence of inherent complication. Repairing the root perforation promote the proper healing of the periapical tissue and increase the success rate of retreatment.


  1. Garg N, Garg A. Textbook of Endodontics. 3rd ed. New Delhi: Jaypee Brothers Medical Publishers; 2014. p. 321, 351, 377-380, 382, 404.
  2. Hargreaves KM, Berman LH. Cohen’s Pathways of the Pulp. 11th ed. St. Louis: Elsevier; 2016. p. 26-27, 37, 51, 334, 374-377.
  3. Kaur M, Singh H, Dhillon JS, Batra M, Saini M. MTA versus Biodentine: Review of literature with a comparative analysis. J Clin Diagn Res. 2017;11(8): ZG01-5.
  4. Kaup M, Schafer E, Dammaschke T. An in vitro study of different material properties on Biodentine compared to ProRoot MTA. Head Face Med. 2015;11(16):1-8.
  5. Bergenholtz G, Horsted-Bindslev P, Reit C. Textbook of Endodontology. 2nd ed. West Sussex: Wiley-Blackwell; 2010. p. 5, 220.
  6. Hegde M, Varghese L, Malhotra S. Tooth root perforation repair-a review. OHDM. 2017;16(2):1- 4.
  7. Balasubramaniam R, Krishnan A, Jayakumar S. Restoring the dignity: Case reports of root perforation management. Int J Applied Dent Sci. 2017;3(3):171-4.
  8. Gupta R, Shama P, Gupta B. Treatment of perforated canal-a case report. Annals Dent Spec. 2015;3(3):80-1.
  9. Aidasani GL, Mulay S. Management of iatrogenic errors: furcal perforation. J Int Clin Dent Res Org. 2018; 10(1):42-6.
  10. Torabinejad M. Mineral Trioxide Aggregate Properties and Clinical Application. 1st ed. West Sussex: Wiley-Blackwell; 2014. p. 14, 19-20, 26-29.
  11. Anusavice KJ, Shen C, Rawls HR. 12th ed. St. Louis: Elsevier; 2013. p. 332, 427, 447-448, 453.
  12. Saed SM, Ashley MP, Darcey J. Root perforation: etiology, management strategies and outcomes. The hole truth. Br Dent J. 2015;220(4):171-80.
  13. Perdigao J. Restoration of root canal-treated teeth. Switzerland: Springer; 2016. p. 109-111.
  14. Mohammed A. Lithium disilicate (e-max press) based crown for esthetic rehabilitation in esthetic zone: a case report. Journal of Dental Sciences. 2018;3(4):1-6.



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