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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A microbiological and immunological study of endodontic-periodontic lesions. Treatment strategy for guided tissue regeneration in combined endodontic-periodontal lesions: BoxRiyadhSaudi Arabia. Factors influencing radiographic appearance of bony lesions. Eur J Oral Sci.

The most common cause of vertical root fracture in endodontically treated teeth is the excessive force used during lateral condensation of gutta-percha. The relationship of bacterial penetration and pulpal pathosis in carious teeth.

A more chronic response may sometimes lexion without pain, and involves the sudden appearance of a pocket with bleeding on probing or exudation of pus. These lesions often present challenges to the clinician as far as diagnosis and prognosis of the involved teeth are concerned.

Incidence of periapical cysts in relation to the root canal. Walton RE, Torabinejad T, editors. The interrelationship of pulp and periodontal disease. When root perforation occurs, communications between the root canal system and either peri-radicular tissues or the oral cavity may often reduce the prognosis of treatment. The apical foramen decreases in size as the proliferation of the Sheath of Hertwig continues.

Vertical root fractures are most often caused when a tooth, leslon weakened due to undermining by caries, previous restorative treatment or a non-vital pulp pesion traumatised.


International Journal of Dentistry

Vertical root fracture in endodontically versus nonendodontically treated teeth. This paper aims to discuss a modified clinical classification to be considered for accurately diagnosing and treating endo-perio lesion.

J Am Dent Assoc. Teeth with lesions caused by vertical root fractures have a hopeless prognosis and should be extracted.

The influence of endodontic treatment on periodontal wound healing. Rationale for the application of the GTR principle using a barrier membrane in endodontic surgery: To have pedio best prognosis, clinician prrio refer the case to various areas of specialization, to perform restorative, endodontic or periodontal therapy, either singly or in combination.

This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3. They may take on many shapes but generally can be classified as enamel fractures, crown fractures without pulp involvement, crown fractures with pulp involvement, crown-root fracture, root fracture, luxation, and avulsion [ 28 ].

A New Classification of Endodontic-Periodontal Lesions

A conclusive diagnosis for pulpal disease cannot be achieved by visual examination alone. Calcium ion diffusion from calcium hydroxide-containing materials in endodontically-treated teeth: It therefore must always be accompanied by additional tests. Etiologic factors such as bacteria, fungi, and viruses as well as various contributing factors such as trauma, root resorptions, perforations, and dental malformations play an important role in the development and progression of such lesions.

Inflammatory mediators cause destruction of gingival connective tissue, periodontal ligament and alveolar bone. Primary periodontal lesions with secondary endodontic involvement; periodontal disease causes a resultant pulpal lession as it progresses apically.

Lesoin BU, Jacobsen I. Parirokh M, Torabinejad M. Periodontal treatment removes the noxious stimuli and secondary mineralization of dentinal tubules allows the resolution of pulpal hypersensitivity.


Endo-Perio Dilemma: A Brief Review

Fungi in endodontic infections. An evaluation of endodontically treated vertically fractured teeth.

Studies have indicated that this factor may be an important cause of endodontic treatment failure [ 25 — 27 ]. Darkfield microscopy as a diagnostic aid in differentiating exudates from endodontic and periodontal abscesses.

N Z Dent J. Coronal leakage as a cause of failure in root-canal therapy: This suggests that one disease may be the result or cause of the other or even originated from two different and independent processes which are associated with their advancement [ 1 ].

The prognosis of a true-combined perio-endo lesion is often poor lession even hopeless, especially when periodontal lesions are chronic with extensive loss of attachment.

Rotstein I, Simon JH. Prevalence of yeasts in saliva and root canals of teeth associated with apical periodontitis.

Endo-Perio Dilemma: A Brief Review

Int Endod J ; Radiographic appearance of artificially prepared periapical lesions confined to cancellous bone. Knowledge of these disease processes is essential in coming to the correct diagnosis. Carious lesions or any direct exposure to the oral cavity of dentine or pulp may ingress bacteria to contaminate an otherwise sterile lesion.

Mechanisms of antimicrobial activity of calcium hydroxide: Periodontal repair of periapical lesions: The lrsion lesions have been characterized by the involvement of the pulp and periodontal disease in the same tooth. In such cases, it is advisable to treat both tissues [ 23 ].