Root perforations that result in a communication of the root space wit
h the periodontal tissues occasionally occur during endodontic procedu
res. They may be induced iatrogenically, by resorptive process, or by
caries. Identification of root perforations is possible by direct obse
rvation of bleeding, indirect bleeding assessment using a paper point,
radiography, and an apex locator. Prognosis of a tooth with root perf
oration depends on the time lapsed before obturation of the perforatio
n, location and size of the lesion, and the sealability of the repair
material. Perforation defects may be repaired by nonsurgical or surgic
al techniques. A review of causes, diagnosis, prognosis, and managemen
t of root perforations provides information for avoiding, detecting, a
nd treating of such defects.