It provides several advantages for the diagnosis and treatment planning of endodontic problems. 6, 7ĬBCT is a type of computed tomography, in which a cone-shaped beam is used. This limitation has been overcome by the use of 3-dimensional computed tomography and cone-beam computed tomography (CBCT). 5 The main limitations of intraoral radiographs include 2-dimensional imaging of a 3-dimensional object and the superimposition of anatomical structures and cortical bone covering the area these factors complicate the accurate visualization of the perforation site and make it difficult to estimate its extent. Radiographs provide beneficial information for the diagnosis, treatment, and follow-up of endodontically treated teeth. In addition to clinical signs and symptoms, several devices and methods have been suggested for the clinical detection of root perforations, such as electronic apex locators, surgical microscopes, endoscopes, and optical coherence tomography scans however, none of these devices can detect perforations in endodontically treated teeth (filled roots). Thus, immediate aseptic treatment techniques are associated with high rates of success. Prompt diagnosis and treatment decrease the risk of infection of the perforated site and often result in an optimal response by the periradicular tissue. 1, 3 The time interval between diagnosis and treatment and the site of perforation are the most important factors determining the prognosis. Several factors, such as the time of diagnosis and treatment, as well as the size and location of the perforation, affect the prognosis of treatment. 2 Evidence shows that the process of healing takes place 31% more slowly in teeth with root perforation than in teeth without root perforation. Root perforation occurs in 2%–12% of endodontically treated teeth. When root perforation occurs, it compromises the periradicular tissue, and if it is not treated or if treatment is delayed, tooth extraction may be necessary. 1 Root perforation most often occurs due to operator error, and can happen at any step during root canal treatment. Root perforation is defined as a pathological mechanical communication between the root canal and the periodontal tissue supporting the tooth.
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