The authors used combined reconstructive and regenerative therapy to treat a patient who had a surgically created osseous defect that also was associated with a perforated root canal. The defect involved a maxillary canine that exhibited 10 millimeters of attachment loss on its mesial surface. Tetracycline root surface conditioning, glass ionomer cement, a decalcified freeze-dried bone allograft and an expanded-polytetrafluorethylene membrane were used to achieve a 7- to 8-mm gain in clinical attachment level two years after the initial surgery. This case illustrates the use of glass ionomer cement, in conjunction with regenerative therapy, to effectively treat a root perforation adjacent to a periodontal osseous defect.