Perforations: Prophylaxis

The following measures greatly reduce the risk of different types of perforations:
1) always use the diagnostic radiograph to locate the pulp chamber and the
canals
2) at the first appointment, put the rubber dam on after locating the canals
3) reserve enough time for access cavity preparation and canal localisation
4) use a sharp probe, good light, fiber optics, and loops or microscope
5) use ultrasonics to render the pulp chamber free from old filling materials
6) take additional radiographs when necessary
7) select correct instruments for different types of canals
8) use correct techniques for each instrument type and canal