
Despite the development of endodontic therapy, adverse complications can arise during treatment resulting in a questionable prognosis. Perforation is one such complication associated during the operative stages of endodontic treatment, particularly with failure to observe the anatomic variations of different tooth types. Various materials have been suggested and used to repair root canal perforations, including calcium hydroxide, silver amalgam, mineral trioxide aggregate (MTA), and glass ionomer cement. This report describes the clinical management of a mandibular molar in which periapical radiography showed satisfactory canal obturation, but with a lateral perforation present at the floor level. Initial treatment involved sealing of the perforated area with resin-modified glass ionomer cement, followed by completion of root canal retreatment and canal sealing with composite-resin followed by reconstruction with metal ceramic crown. There was favourable clinical and radiographic progression at 3months and 6 year follow-up. We thus conclude that tooth longevity can be prolonged even in the presence of a perforation.