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.

Author: Tozuru Gajas
Country: Andorra
Language: English (Spanish)
Genre: Medical
Published (Last): 18 June 2005
Pages: 192
PDF File Size: 19.86 Mb
ePub File Size: 11.33 Mb
ISBN: 432-1-65131-449-1
Downloads: 85535
Price: Free* [*Free Regsitration Required]
Uploader: Mikazil

Primary periodontal disease with secondary endodontic involvement and true combined endodontic-periodontal diseases require both endodontic and periodontal therapies.

Subscribe to Table of Contents Alerts. Root perforations may result from extensive carious lesions, resorption, or from operator error occurring during root canal instrumentation or post preparation. In others, periodontal pathology may create pulpal pathology.

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. Due to the complexity of these affections, an interdisciplinary approach with a good collaboration between endodontists, periodontologists and microbiologists, is recommended.

Wright Publishing Company; Ten Cate A R. Primary endodontic lesions with secondary periodontal involvement may also occur as a result of root perforation during root canal treatment, or where pins or posts have been misplaced during coronal restoration.

A perio-endo lesion can have a varied pathogenesis which ranges from quite simple to relatively complex one. Perforations may be produced by powered rotary instruments during the attempt to gain access to the pulp or during preparation for a post. An in vitro study. Effects on periodontal healing in mature and immature replanted monkey teeth.

International Journal of Dentistry

Three case reports with two-year follow-up. The actual relationship between periodontal and pulpal disease was first described by Simring and Goldberg in Case report and review. Prevalence, aetiology, and diagnosis. This causes local tissue hypoxia and anoxia resulting in localized necrosis, the chemical mediators of which cause further localized oedema, completing the cycle. This review article discusses fndo various clinical aspects to be considered for accurately diagnosing and treating endo-perio lesions.


Enfo of the periodontal disease and the pocket leads to pulpal involvement via either a lateral canal foramen or the main apical foramen. Vertical root fracture in endodontically versus nonendodontically treated teeth.

Lesion characteristics and diagnostic features of endo-perio lesions Click here to view. Barrier membrane technique in endodontic microsurgery. A periapical lesion may perforate the cortical bone close to the apex, elevate the periosteum and overlying soft tissues, and drain into the gingival sulcus, 36 and form pseudopockets that simulate periodontal disease without necessarily permanent damaging of the cementum and its fibres.

Effect of intracoronal bleaching on external cervical root resorption.

Having enough knowledge of these disease processes is essential in coming to the correct diagnosis. This condition may mimic, clinically, the presence of a periodontal abscess. It is known that the main cause of the periodontal lesions is leeion presence of the bacterial plaque, formed by aerobic and anaerobic microorganisms [ 9 — 12 ].

Endo-Perio Dilemma: A Brief Review

Precautions should be taken to prevent in vivo seeding of such micro-organisms, particularly in compromised teeth and hosts. A histologic evaluation of dental pulp tissue of a patient with periodontal disease. The endo-perio problem in dental practice: Even with apparently successful treatment, the tooth will still be compromised as there is likely to be some gingival recession and loss of periodontal attachment and bone support.

Int Endod J ; An in vitro comparison of the sealing ability of materials placed in lateral root perforations. Influence of pulpal treatments on cell and tissue reactions in the marginal lfsion.

A New Classification of Endodontic-Periodontal Lesions

It remains patent and serves as the communication on which the pulpal tissues rely for nutrition and nervous innervation. Rationale for the application of the GTR principle using a barrier membrane in endodontic surgery: Prospective clinical study evaluating endodontic microsurgery outcomes for cases with lesions of endodontic origin compared with cases with lesions of combined periodontal-endodontic origin.


A new approach to the treatment of true-combined endodontic-periodontic lesions by the guided tissue regeneration technique. Journal of International Dental and Medical Research.

Figdor D, Sundqvist G. There is a general agreement today that the vast majority of pulpal and periodontal lesions are the result of bacterial infection. International Journal of Dentistry. Some periodontal lesions of endodontic origin can heal following root canal treatment alone. The interrelationship of pulp and periodontal disease. The use of non-toxic intracanal perlo medicaments is essential to destroy bacteria and to help encourage tissue repair.

Reeves R, Stanley HR. Differentiating between periodontal and endodontic problems can be difficult. One of the main classification items was primary endodontic disease, which we believe should be modified, since it has no periodontal relationship.

The simplified papilla preservation flap in the regenerative treatment of deep intrabony defects: As it is bactericidal, anti-inflammatory and proteolytic, it inhibits resorption and favors repair. Support Center Support Center.

Endo-perio lesions: Diagnosis and clinical considerations Shenoy N, Shenoy A – Indian J Dent Res

Etiologic factors such as bacteria, fungi, and viruses as well as other various contributing factors such as perip, root resorptions, perforations, and dental malformations also play an important role in the development and progression of such lesions.

The differential diagnosis of endodontic and periodontal diseases can sometimes be difficult but it is of vital importance to make a correct diagnosis so that the appropriate treatment can be provided. Diagnosis, prognosis and decision-making in the treatment of combined periodontal-endodontic lesions.