An endodontic lesion usually involves an irreversibly inflamed or necrotic dead pulp. The differential diagnosis of endodontic and periodontal diseases can sometimes be difficult, but it is of vital importance to make a correct diagnosis for providing the appropriate treatment. This article is an attempt to provide a rational approach to the perio endo endo perio question in order to scientifically diagnose and treat these lesions with predictable success. In the case of a combined endoperio lesion, the endodontic therapy results in healing of the endodontic component, while the prognosis of tooth would finally depend on the healing of the periodontal lesion.
Nonsurgical endodontic management of the combined endoperio lesions. Porto 3, kundabala mala 4 1 faculty of dentistry, divison of oral clinical sciences, international medical university, kuala lumpur, malaysia 2 school of dentistry, international medical university, kuala lumpur, malaysia 3 department of restorative dentistry, cesmac university. This is the reason why these types of process should be. This case report brings to light that there can be a simple solution to a grave looking problem. Primary periodontal lesions with secondary endodontic involvement. Both endodontic and periodontal diseases are caused by a mixed anaerobic infection. Classification, combined lesions, perioendo lesion. The periodontium includes the gingiva,cementum, periodontal ligament pdl. To understand and apply the differential diagnosis of a primary periodontal lesion and a primary endodontic lesion. Sometimes when the pulp becomes necrotic, the infection extends beyond the root of the tooth and resorbs part of the surrounding bone. A new classification of endodonticperiodontal lesions. Endodontic periodontal lesions pdf this book presents a multidisciplinary evidencebased approach to the management of teeth with lesions of endodontic periodontal origin. There is a very obvious continuum in these lesions where, for example, an endodontic infection can easily spread to the periodontium and vice versa.
The subject of combined endoperio lesions is surrounded by considerable confusion. A sequential approach in treatment of endoperio lesion a case report. Endo perio lesions are occasionally encountered complicated dental conditions, difficult to diagnose and treat. The book opens by addressing the etiology and classification of endodontic periodontal lesions, and demonstrates its relevance to the daily practice. Whereas the endoperio lesion will often produce resolution of the joint problem with endodontic treatment alone, the perioendo lesion will still require periodontal treatment and even then the prognosis is far poorer. Endoperiodontal lesion endodontic approach europe pmc. The tooth remained untreated and consequently the two. However, in cases of combined disease, the prognosis of combined diseases rests with the severity and extent of the periodontal lesion and the efficacy of periodontal therapy.
Primary endodontic lesions with secondary periodontal involvement. In the case of a combined endo perio lesion, the endodontic therapy results in healing of the endodontic component of involvement while the prognosis of tooth would finally depend on the healing of the periodontal structures. If we were to look at endoperio lesions that began from the endodontic tissue, there are a number of potential causes. Acute periodontal lesions periodontal abscesses and necrotizing. The apical foramen is the main access route between the pulp and the periodontium, with the.
A healthy, 65yearold male presented with pain and swelling in the lower left quadrant. An endodonticperiodontal lesion consists of concurrent pulpal and periodontal disease in the same tooth. The endo perio lesion is a condition characterized by the association of periodontal and pulpal disease in the same dental element. In conclusion, it is essential to understand that in perioendo lesions, the endodontic treatment is the more predictable of the two. An endo perio lesion can have a varied pathogenesis which ranges from simple to relatively complex one. Endoperio lesions might be interdependent because of the vascular and anatomic connections between the pulp and the periodontium. The endoperio lesion may be the most complex, recalcitrant localized problem we encounter. A 56yearold male patient with an endoperio lesion in the right mandibular first molar was initially treated with endodontic therapy. Treatment and prognosis of endodonticperiodontal diseases vary and depend on the. Supported by a thorough analysis of the diagnostic, etiopathogenic, and clinical factors, the author of this succinct book proposes new terminology and a simplified classification of endoperiodontal lesions that shed light on an ambiguous pathologic situation that is often misinterpreted in clinical practice. One frequently hears diagnoses of endoperio lesions when in fact there is an endodontic lesion mimicking periodontal disease or, vice versa, a purely periodontal lesion perfectly is camouflaged as an endodontic pathology. Both an endodontic and periodontal lesion devel oping independently and progressing concur rently meet and merge at a.
Endodonticperiodontal lesions present challenges to the clinician as far as diagnosis and. Easily share your publications and get them in front of issuu s. Issuu is a digital publishing platform that makes it simple to publish magazines, catalogs, newspapers, books, and more online. The following case is intended to give insight into and even possibly make us question some of our decisionmaking before we condemn a suspected endoperio involved tooth. The relationship between periodontal and pulpal disease was first described by simring and goldberg in 1964. A case series associated with different kinds of endo. In order to understand this process, we start from the assumption that there are only two origins.
Endo perio lesions by ijstr research publications issuu. An endoperio lesion can have a varied pathogenesis which ranges from simple to relatively complex one. Since then, the term perio endo lesion has been used to describe lesions due to inflammatory products found in varying degrees in both the periodontium and the pulpal tissues. This is a case report on an endodontic lesion with periodontal involvement that has. Syed wali peeran, madhumala thiruneervannan, khaled awidat abdalla, marei hamed mugrabi. The aim of this study is to emphasise that primary endodontic lesion heals after a proper instrumentation, disinfection and sealing of the endodontic space. For differential diagnosis and treatment purposes, endo perio lesions are classified as either. Review and clinical study kumar, rahul, khambete, neha on. The health of the periodontium is importantto the proper function of a tooth.
Simon endodonticperiodontal lesions present challenges to the clinician as. How to diagnose and treat periodontal endodontic lesions. Merged lesions form by ongoing marginal attachment loss or by exacerbations of apical. The followup radiographs showed complete healing of the hard and soft tissue lesions. An endoperio legion can have a varied pathogenesis which ranges from quito simple to rolutively complex. These types of lesions can be a devil to diagnose and treat successfully. The tooth with endoperio lesions should be evaluated thoroughly in terms of any cracks. Ijcr is following an instant policy on rejection those received papers with plagiarism rate of more than 20%.
The true endoperio lesion can be produced only from independent endo and perio lesions, that merge together in a tooth. A better treatment plan leads to a better result as seen in this case report. Endodontic periodontal relationship, endo perio lesion. For differential diagnosis and treatment purposes, endoperio lesions are classified as either. The main objective of this paper was to report the clinical effectiveness of leukocyte platelet rich fibrin lprf in the treatment of a combined endoperiodontal lesion of an.
Endo perio lesions are a common finding in the dental practice. The two lesions can either merge or exist separately. Easily share your publications and get them in front of issuus. And the missing patterns of endoperio lesions were identified, and then. Endoperio lesions periodontology notes dentalnotebook.
Pdf endoperio lesions are occasionally encountered complicated dental conditions, difficult to diagnose and treat. The most conventional classification used for endodontic periodontal lesions was given by simon et al. A diagram that summarises lesion development the relationships between them. In this case report, different kinds of endoperio lesion were treated with sequential endodontic and periodontal treatment. Endo perio lesion, flap surgery, rct, bone grafts endodontic lesion, if allowed leads to periodontal involvement or vice versa. Endo perio lesion has a complex pathogenesis and requires great skill to identify and treat it. Concomitant endoperio lesion is an additional classification that has been proposed to describe the presence of endo and perio disease as two separate and distinct entities. D between lesions of periodontal origin and endodontic origin. A dilemma from 19 th until 21 st century abhishek parolia 1, toh choo gait 2, isabel c. Radiograph shows separate progression of endodontic disease and periodontal disease.
Mineral trioxide aggregate in treatment of permanent teeth. The success of a combined periodontal and endodontic lesion depends on the elimination of both of these disease processes. To describe major pathways of communication between the pulp and periodontal tissue, and to identify possible etiologies for perioendo lesions. A clinical dilemma pushpendra kumar verma 1, ruchi srivastava 2, kk gupta 2, amitabh srivastava 2 1 department of conservative dentistry and endodontics, sardar patel postgraduate institute of dental and medical sciences, lucknow, uttar pradesh, india 2 department of periodontology and implantology, sardar patel postgraduate institute of dental and. The complexity of endoperio lesions reflects the relevance of a close developmental. A sequential approach in treatment of perio endo lesion. Acute periodontal lesions periodontal abscesses and. To be able to make an appropriate treatment plan, including alternative therapies.
Cooperation between different disciplines that includes periodontology, endodontic and prosthodontics is required to effectively treat the lesion. Clinical effectiveness of combining platelet rich fibrin with. Nonsurgical endodontic management of the combined endo. Endodontics lecture irrigants and intracanal medicaments. Successful management of teeth with different types of endodontic. The specialist diagnosed severe retrognathia and tooth. Bacterial ecosystem of chronic lesion adapts itself and becomes more resistant to endodontic and periodontal treatments 19, 21, 22. Management endodontic periodontal lesion primary endo lesion primary perio lesion combined lesion endodontic therapy perio therapy primary endo secondary perio primary perio secondary endo first endo, evaluate, if required perio perio surgery, palliative rct, regenerative procedures parolia, et al. Combined periodonticendodontic lesions take the form of abscesses and can originate from either or both of two distinct locations and may be informally subclassified as follows.
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