Managing a Ledge and Coronal Perforation in a Curved Canal

This case came to me with gutta-percha already placed inside the canal for radiographic evaluation. The colleague explained, “I was in a hurry and went in with an orifice opener without first creating a glide path. I ended up with a ledge, tried to enlarge coronally to pass it — and caused a perforation. From the start, it was clear: this wasn’t just a mechanical problem, it was a lesson in mindset.Endodontics rewards patience — and punishes haste. Assessment and Initial Management Upon access, I irrigated gently to evaluate the situation. Severe bleeding was evident, indicating a coronal perforation in the MB canal. At this point, visualization was impossible, and proceeding blindly would only worsen the problem. Bleeding control came…