Pulpal and periodontal problems are responsible for more than 50% of tooth mortality today. An endo-perio lesion can have a varied. An endo-perio lesion can have a varied pathogenesis which ranges from simple to relatively complex one. The differential diagnosis of. 10 steps to efficient endo in the general practice. For differential diagnosis and treatment purposes, “endo-perio” lesions are classified as either.

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Several authors, through their studies, diverge on the contamination routes.

Periodontitis Associated with Endodontic Disease. An in vitro comparison of the sealing ability of materials placed in lateral root perforations. Incidence of external root resorption and esthetic results in 58 bleached pulpless teeth. In such cases, pfrio is not essential to determine which disease entity occurred first as the treatment will involve both endodontic and periodontal management.

Iatrogenic root canal perforations: Table of Contents Alerts. Radiographic and clinical evaluation can help clarify the nature of the problem. If the periodontium had a previous inflammation, it may lead to dissemination of the inflammation which can result in pulp necrosis [ 17 ].


Complete healing after 6 months Click here to view. Introduction The endodontium and periodontium are closely related and diseases of one tissue may lead to the involvement of the other. It has been recognized that the success of the treatment depends mainly on immediate sealing of the perforation and appropriate infection control.

Milano F, Melsen B. J Am Dent Assoc.

Diagnosis is complicated by the fact that these diseases are too frequently viewed as independent entities. Mild pain or discomfort and swelling are the major clinical symptoms, and solitary pocket around one aspect of the suspected tooth is the major clinical sign.

The prognosis of these cases depends on the severity of periodontal disease and the lesioon to periodontal treatment.

This makes it difficult to diagnose because a single lesion may present signs of both endodontic and periodontal involvement. Treatment map of endodontic-periodontal lesions Click here to view.

Endo-Perio Dilemma: A Brief Review

J Mich Dent Assoc ; Please review our privacy policy. Treatment strategy for guided tissue regeneration in combined endodontic-periodontal lesions: Cvek M, Lindvall AM. Relationship between periapical and periodontal status. Some periodontal lesions of endodontic origin can heal following root canal treatment alone.


Figdor D, Sundqvist G.

Endo-Perio Dilemma: A Brief Review

This causes local tissue hypoxia and anoxia resulting in localized necrosis, the chemical mediators of which cause further localized oedema, completing the cycle. The prognosis of a true-combined perio-endo lesion is often poor or even hopeless, especially when periodontal lesions are chronic with extensive loss of attachment.

In others, periodontal pathology may create pulpal pathology. Teeth with lesions caused by vertical root fractures have a hopeless prognosis and should be extracted.

Endodontic complications following periodontal and prosthetic treatment of patients with advanced periodontal disease.

International Journal of Dentistry

If a lesion is diagnosed and treated as nedo primarily endodontic disease due to lack of evidence of marginal periodontitis, and there is soft-tissue healing on clinical probing and bone healing on a recall radiogragh, a valid retrospective diagnosis can then be made. The pulpal pocket approach: It therefore must always be accompanied by additional tests.

Periodontal disease, bacteria, and pulpal histopathology.