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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If a draining sinus tract through the periodontal ligament is present before root canal treatment, resolution of the probing defect is expected.

Lewion and periodontic interelationships.

N Z Dent J. Int J Periodontics Restorative Dent ; Another classification was recommended by the world workshop for classification of periodontal diseases [ 22 ], Periodontitis Associated with Endodontic Disease: Endotoxins produced by plaque bacteria also have an irritant effect on overlying soft tissue, preventing repair.

To have the best prognosis, clinician should refer the case to various areas of lesiob, to perform restorative, perioo or periodontal therapy, either singly or in combination.

The endo-perio lesion is a condition characterized by the association of periodontal and pulpal disease in the same dental element. The nature of that pain is often the first clue in determining the etiology of such a problem.

Endodontic infection and calcium hydroxide-treatment. The relationship of bacterial penetration and pulpal pathosis in carious teeth.

If a lesion is diagnosed and treated as a primarily endodontic lssion 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. How to cite this article: This condition is most often seen as a complication of luxation injuries, especially in avulsed teeth that have been out of their sockets in dry conditions for several hours.


The prognosis and treatment of each endodontic-periodontal disease type varies. Pesion new endodontic-periodontal interrelationship classification, based on the primary disease with its secondary effect, is suggested as follows: Principles and Practice of Endodontics. A comprehensive literature review – Part III: They are separated by the formation and development of tooth bud from the overlaying ectoderm into enamel and dentine.

The endo-perio lesion is a condition characterized by the association of periodontal and pulpal disease in the same dental element. Vitality testing should be carried out on relevant teeth as well as radiographic examination, paying close attention to shape, location and extension of any lesion, crestal and furcation involvement and signs of fracture or perforation. Certain chemicals used in dentistry have the potential to cause root resorption. J Clin Periodontol ; Important qualities of cross-infecting organisms may be the ability to survive in highly reduced environments and motility.

Endo-Perio Dilemma: A Brief Review

The successful treatment of root perforations depends principally on early detection and sealing. Characterization of new periodontal and endodontic isolates of spiro chetes. A histologic evaluation of periodontal tissues adjacent to root perforations filled with Cavit. Knowledge of these disease processes is essential in coming to the correct diagnosis. Some authors such as Rubach and Mitchell [ 18 ] affirmed that the periodontal disease may affect the pulp when there is exposure of the accessory canals through the apical foramina and the canaliculi in the furcation.

External resorption associated with bleaching of pulpless teeth. Endodontic pathogens in periodontal disease augmentation. Calcium hydroxide, leskon resorption, endo-perio lesions. Although the prognosis is deemed poor, it appears that a successful outcome can frequently be achieved. The influence of enfo infection on progression of marginal bone peeio in periodontitis.

The endodontic-periodontal continuum revisited: Czarnecki RT, Schilder H. Lindhe [ 19 ] also reported that bacterial infiltrates of the inflammatory process may reach the pulp when there is accessory canal exposure, through apical foramens and canaliculi of the wndo area.


Related articles Endo-perio lesions periodontal pulpal diagnosis. Periodontal repair of periapical lesions: The endo-perio problem leison dental practice: J Mich Dent Assoc ; It therefore must always be accompanied by additional tests. Acute exacerbation of a chronic apical lesion on a tooth with a necrotic pulp may drain coronally through the periodontal ligament into the gingival sulcus.

J Am Dent Assoc.

Endo-Perio Dilemma: A Brief Review

This is achieved by careful history taking, examination, and performing special tests. Improper manipulation of endodontic instruments can also lead to a perforation of the root. Diagnosis of teeth with necrotic pulps can be difficult to establish.

The sinus tract extending lesiion the gingival sulcus or furcation area disappears at an early stage once the affected pulp has been removed and the root canals well cleaned, shaped, and obturated.

The most important factor in the treatment is a correct diagnosis which is achieved by careful history taking, examination and the use of special tests. Granulation tissue derived from bone or gingival connective tissue may induce root resorption and ankylosis [ 1731 ]. The apical foramen decreases in size as the proliferation of the Sheath of Hertwig continues. Endodontic effects of root planning in humans.

On the other hand, in a tooth ejdo primary periodontal disease, the pulp is vital and responsive to testing. This is an open access article distributed under the Creative Commons Attribution Licensewhich permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Some periodontal lesions of endodontic origin can heal following root canal treatment alone.

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