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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Treatment of traumatic dental injuries varies depending on the type of injury and it will determine pulpal and periodontal ligament healing prognosis [ 1729 — 33 ]. A proposal of classification and literature review. This paper is an attempt to provide a rational classification to the endo-perio question in order to scientifically diagnose and treat these lesions with predictable success. Several authors, through their studies, diverge on the contamination routes.

Treatment map of endodontic-periodontal lesions Click here to view. Microleakage of dentin-bonded crowns placed with different luting materials. The relationship of bacterial penetration and pulpal pathosis in carious teeth.

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. Symptoms may be acute, with periodontal abscess formation associated with pain, swelling, pus exudate, pocket formation, and tooth mobility. The most common cause of vertical eneo fracture in endodontically treated teeth is the excessive force used during lateral condensation of gutta-percha. Find articles by Preetinder Singh.

Diagnostic procedures used to identify the endo-perio lesion Click here to view. A survey of cases in Chinese patients. Relationship between periapical and periodontal status.

Cervical root resorption following bleaching of endodontically treated teeth. This is achieved by careful history taking, examination, and performing special tests.


The use of guided tissue regeneration principles in endodontic surgery for induced chronic periodontic-endodontic lesions: Indian J Dent Res ; An experimental study in the monkey. The endodontium and periodontium are closely related and diseases of one tissue may lead to the peeio of the other. Endotoxins produced perjo plaque bacteria also have an irritant effect on overlying soft tissue, preventing repair.

Widening of the periodontal ligament along one or both sides of the root, or bone loss in solitary tooth are the major radiographic findings.

Precautions should be taken to prevent in vivo seeding of such micro-organisms, particularly in compromised teeth and hosts.

If a lesion is diagnosed and treated as a 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.

View at Google Scholar F. Therefore, this presentation will highlight the diagnostic, clinical guidelines and decision-making in the treatment of these lesions from an Endodontist’s point of view to achieve the best outcome. Etiologic factors such as bacteria, fungi, and viruses as well as other various contributing factors such as trauma, root resorptions, perforations, and dental malformations also play an important role in the development and progression of such lesions.

It is important to remember that the recognition of pulp vitality is essential for a differential diagnosis and for the selection of primary measures for treatment of inflammatory lesions in the marginal and apical periodontium.

This would increase the likelihood of cumulative damage to the pulp. The pulpal pocket approach: A conclusive diagnosis for pulpal disease cannot be achieved by visual examination alone.


Classification and clinical indications. New attachment following surgical treatment of human periodontal disease.

International Journal of Dentistry

Diagnosis and treatment planning. The interrelationship of pulp and periodontal disease. Primary periodontal lesions with secondary endodontic involvement; periodontal disease causes a resultant pulpal necrosis as it progresses apically. J Calif Dent Assoc. The successful treatment of root perforations depends principally on early detection and sealing.

The tooth has a pulpless, infected root canal system and a coexisting periodontal defect. J Clin Periodontol ; An endo-perio lesion can have a varied pathogenesis which ranges from quite simple to relatively complex one. The periodontal disease has gradually spread along the root surface towards the apex. E Vertical Root Fractures. The simplified papilla preservation flap in the regenerative treatment of deep intrabony defects: The pulp and periodontium have embryonic, anatomic and functional inter-relationships.

Madison and Wilcox [ 13 ] found that exposure of root canals to the oral environment leads to coronal leakage, and in some cases along the entire length of the root canal.

A New Classification of Endodontic-Periodontal Lesions

Progression of the periodontal disease and the pocket leads to pulpal involvement via either a lateral canal foramen or the main apical foramen. Moreover, the dentinal fluids move towards the exterior, thereby reducing the diffusion of the harmful products of the bacteria on the exposed dentin.

This paper aims to discuss eneo modified clinical classification to be considered for accurately diagnosing and treating endo-perio lesion.

Clin Oral Investig ;4: Scand J Dent Res. Categorization of periodontal lesions into two sub- categories: