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Iatrogenic root perforations are an unfortunate accident that can occur during dental treatment and can lead to peri-radicular damage, poor treatment outcome and extraction of the tooth. The aim of this review was to analyse the occurrence and risk factors for root perforation. A systematic search of the literature was conducted in CINAHL, Cochrane, EMBASE, Medline and SCOPUS in May 2019. Additional literature was identified through a hand search. Clinical studies enrolling adults with permanent dentition were included. Single case stud