Here are many reasons why a perforation is an undesirable complication during RCT (in my order of worst to last) 1. It removes hard tissue unnecessarily reducing fracture resistance 2. It creates a portal of entry for fluid to enter the canal and feed any micro organims that survived root canal treatment to continue to thrive 3. It acts as a portal of exit for bacterial toxins to enter the periodontal tissues - this adds another tissue involved in the infection in a position that maybe links up
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