Bacterial infection is the main cause for pulpal and periodontal disease. Hears diagnoses of endo perio lesions when in fact there is an endodontic. In this case report, different kinds of endo perio lesion were treated with sequential endodontic and periodontal treatment. 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. A sequential approach in treatment of perioendo lesion. Perio endo lesion pdf consequences of periodontalendodontic lesions, as well as its clinical. The term perio endo lesion has been used to describe lesions from inflammatory products which are found in varying. A dilemma from 19 th until 21 st century abhishek parolia 1, toh choo gait 2, isabel c. Learn vocabulary, terms, and more with flashcards, games, and other study tools. The periodontal endodontic lesions have received several classifications, among which is the classification of simon et al.
Pre treatment clinical and radiographic view post treatment clinical and radiographic view fig 3. Ijcr is following an instant policy on rejection those received papers with plagiarism rate of more than 20%. In some cases, the influence of pulpal pathology may create periodontal involvement. Saquib2 prof and head1 post graduate student2 email for correspondence. The followup radiographs showed complete healing of the hard and soft tissue lesions. In this report the pulp vitality test which showed the nonvital nature of the tooth was a pivoting finding suggesting the primary endodontic involvement. Finally, while true combined endo perio lesions are much less frequently encountered, they are found when periapical endodontic lesions increase in size and enlarge in a coronal direction, while at the same time a periodontal pocket progresses apically and the two lesions subsequently join. The evaluation of computed tomography scans and ultrasounds in the differential diagnosis of periapical lesions vivek aggarwal, mds, ajay logani, mds, and naseem shah, mds abstract traditionally, the definitive diagnosis of periapical lesion depends on histopathological examination of the tissues, which is impractical in cases planned for non. Lesion with bone defect in the apex which may invade the buccallabial and lingual cortex. To critically evaluate the existing literature on acute lesions occurring in the periodontium periodontal abscesses pa, necrotizing periodontal diseases npd, and endo. Endodontic periodontal combined lesion is a clinical dilemma because making a differential diagnosis and deciding a prognosis are difficult.
Endodontic periodontal lesions dr shabeel pn pa and furcation involvement also the furcation healed and the probe doesn t go in so much the first thing you. The book opens by addressing the etiology and classification of endodonticperiodontal lesions, and demonstrates its relevance to the daily practice. This case report describes the successful management of a left mandibular first molar with a combined periodonticendodontic lesion in a 35yearold caucasian woman with aggressive periodontitis using a concerted approach including endodontic treatment, periodontal therapy, and a periodontal regenerative procedure using an enamel matrix derivate. Periodontal endodontic lesion, perio endo lesion treatment. Introduction primary pulpal infection leading to periradicular periodontitis both infections occur simultaneously as independent perio. A new classification of endodonticperiodontal lesions hindawi.
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. The interrelationship between periodontal and endodontic disease has always aroused confusion, queries, and controversy. The use of nontoxic intracanal therapeutic medicaments is essential to destroy bacteria and to help encourage tissue repair. The apical foramen is the main access route between the pulp and the periodontium, with the. A case report pradeep gade1,krishnaveni chunduru2,u. Endodonticperiodontal lesions present challenges to the clinician as far as diagnosis and prognosis of the involved teeth are concerned. After root canal treatment, an intracoronal splint was constructed and periodontal. Simon endodonticperiodontal lesions present challenges to the clinician as far as diagnosis and prognosis of the involved. An endo perio lesion is one of the most common problems. Pdf periodontal aspects of endodonticperiodontal lesions. A close relationship exists between disease of the dental pulp and periodontal disease, and it expresses itself in several ways. In this process, chronic periodontitis progresses apicallyalong the root surface.
Endo perio abscess gingival abscess periodontal abscess out of the scope part 3. The case becomes more confusing when the patient only comes with the history of pain along with tooth discoloration. Typically, pulp and periodontal pathology respectively, has an evolution of its own. For differential diagnosis and treatment purposes, endo perio lesions are classified as either. Lesion is a broad term, including wounds, sores, ulcers, tumors. Clinical radiological aspects of primary endodontic.
However, there are clinical situations in which the two types of tissue lesions events intertwine, this context being generically known as an endo periodontal syndrome. Oral pyogenic granuloma in pregnancy an oral pyogenic granuloma can develop immediately following the first trimester of pregnancy. These lesions are primarily caused by periodontalpathogens. Endo perio lesions are a common finding in the dental practice. A symptomatic tooth may have pain of periodontal andor pulpal origin. Guide to diagnosing treating endodontic periodontal lesions. Since then, the term perioendo lesion has been used to describe lesions due to inflammatory products found in varying degrees in both periodontium and pulpal. B oneyear followup radiograph showing bony healing.
Endoperio lesions international journal of scientific. Periodontal abscesses pa are important because they repre. Successful management of teeth with different types of endodontic. A postoperative radiograph showing multiple lateral canals in a mandibular second molar with apical and furcal radiolucencies. Endoperiodontal lesion endodontic approach europe pmc. The nature of that pain is often the first clue in determining the etiology of such a problem. The evaluation of computed tomography scans and ultrasounds. So, all of authors and contributors must check their papers before submission to making assurance of following our antiplagiarism policies. As you can we have a diagnostic dilemma, if the perio endo lesion has advanced to the point that the pulp is nonvital. The relationship between pulpal and periodontal disease was first described by simring and goldberg in 1964. Many authors researched about this, but there are many disagreements. The most commonly used classification was given by simon, glick and frank in 1972 figure 3. Dec 27, 2010 the success of a combined periodontal and endodontic lesion depends on the elimination of both of these disease processes. This sets off whats called an inflammatory response because the body sees the debris as a foreign invader.
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. The subject of combined endo perio lesions is surrounded by considerable confusion. Syed wali peeran, madhumala thiruneervannan, khaled awidat abdalla, marei hamed mugrabi. The tooth with endo perio lesions should be evaluated thoroughly in terms of any cracks.
Endo perio lesions are a challenging condition for the dental professionals regarding the diagnosis and treatment for the same. Usually an oral pyogenic granuloma is a slowgrowing mass that does not, upon excision, leave a large defect in the periodontium requiring surgical repair. Periodontology diagnosis combined periodonticendodontic. This is a case report on an endodontic lesion with periodontal involvement that has been treated by performing root canal treatment rct followed by. Endodontic lesions are most frequently initiated and sustained by the apical foramen, followed by accessory and lateral canals,and most infrequently by dentinal tubules. Endo perio lesion is a lesion having both endodontic and periodontal origin. Combined periodontic endodontic lesions take the form of abscesses and can originate from either or both of two distinct locations and may be informally subclassified as follows. Periodontal endodontic lesions are often changes that affect all teeth due to the close relationship between pulp and periodontium. Periodontalendodontic lesions are often changes that affect all teeth due to the close. It is difficult to differentiate it from the endo perio lesion. An endo periodontal lesion is defined as a pathological communication between the endodontic and periodontal tissues of a given tooth. An endodonticperiodontal lesion consists of concurrent pulpal and periodontal disease in the same tooth. The primary endodontic lesion with a secondary periodontal involvement first requires an endodontic therapy and, in the second stage, a periodontal therapy. The severity of the periodontal disease efficacy of periodontal therapy response of the patient.
The best guide i have for differentiating the two is the fact that periodontal lesions generally are not present around a single tooth. Progression of an endodontic lesion, if allowed leads to periodontal involvement or vice versa. Endoperiodontal lesion edoardo foce bok 9781850972105. Successful endodontic treatment is based not only on the absence of periapical pathology but upon the longterm retention and function of the treated tooth. In most cases, pulp tests indicate a clinically normal pulpalreaction. The prognosis for successful management is highly dependent on proper initial classification and subsequent sequencing of treatment. Root amputation, hemisection or bicuspidization maybe done to save part of. How to diagnose and treat periodontal endodontic lesions. Prognosis of primary periodontal lesions depends on 1. Generally, in a case of combined endo perio lesion, an adequate endodontic therapy would. Conversations occur daily between periodontists, endodontists, and general practitioners to try and ascertain whether a lesion surrounding one or more teeth is of periodontal or endodontic origin or is possibly is a true combined lesion that impacts both compartments and will require endodontic as well as subsequent periodontal.
Lesions of the periodontal ligament and adjacent alveolar bone may originate from infections of the periodontium or tissues of the dental pulp. The aim of this study is to emphasise that primary endodontic lesion heals after a proper instrumentation, disinfection and sealing of the endodontic space. Get free endo periodontal lesions endo periodontal lesions recognizing the habit ways to get this books endo periodontal lesions is additionally useful. Acute periodontal lesions periodontal abscesses and. Differentiating between a periodontal and an endodontic problem can be difficult. Simring and goldberg described the relation between pulpal and periodontal disease in 1964simring m et al,1964. Foreword vii foreword the subject of combined endo perio lesions is surrounded by considerable confusion.
A 42yearold woman with an abscess, deep periodontal pockets, and nonvital teeth was treated using a multidisciplinary approach. Retrograde pulpitis, retrograde periodontitis, pulp, periodontium. A new classification of endodonticperiodontal lesions. Most endodontic and periodontal problems are caused by bacteria 1,2,3. Differential diagnosis has always been difficult for periodontal and endodontic diseases. Cases with endodontic periodontal lesions usually present with several clinical and radiological features, such as altered response to testing of pulp sensitivity, clinical signs of gingival inflammation, increased probing pocket depth, sinus tracts, pus secretion and different types of radiological bony defects, several areas of the dentition show periodontal involvement, all of which. A case series associated with different kinds of endoperio. The simultaneous existence of pulpal problems and inflammatory periodontal disease can complicate diagnosis and treatment planning.
Endo perio lesions are occasionally encountered complicated dental conditions, difficult to diagnose and treat. Jul 28, 2016 treatment of periodontalendodontic lesions in cases of true combined lesions. This paper aims to discuss a modified clinical classification to be considered for accurately diagnosing and treating endo perio lesion. This is where you have a combined problem, starting both from your gums, due to periodontal diseaseand from your tooth, due to it dying off. 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. Treatment of a periodonticendodontic lesion in a patient. The relationship between periodontal and endodontic disease has aroused confusion, queries and controversy. The subject of combined endo perio lesions is surrounded by considerable. Terminology is always a difficult thing in dentistry, and endo perio lesions can lead to some confusion. The proper diagnosis and treatment of endo periodontal lesions are challenging for clinicians. According to this classification, perio endo lesions can be classified into. Pdf endodontic periodontal lesions occur as a combination of an endodontic infection and periodontal disease in a single tooth. Mar, 2015 needless to say, successful treatment of endo perio lesions requires successful outcomes in both the endodontic and periodontal component of treatment. A free powerpoint ppt presentation displayed as a flash slide show on id.
Anatomic considerations of the pulpal and periodontal continuum. Ic 74ls164 datasheet pdf the prognosis of a truecombined perioendo lesion is often poor or even hopeless, especially when periodontal lesions are chronic lesiion extensive loss of attachment. Of periodontolgy,gitam dental college and hospital 3. Pdf endo perio lesion a case report semantic scholar.
Endodonticperiodontal lesions pdf this book presents a multidisciplinary evidencebased approach to the management of teeth with lesions of endodonticperiodontal origin. Endodontic periodontal lesionwith primary endodontic lesions andsecondary periodontal involvement of 16 16. Endoperio lesions periodontology notes dentalnotebook. Primary endodontic lesion with secondary periodontal involvement 4. Such lesions can solely be treated by periodontal therapy.
The author discusses the different origins of endo perio lesions and the importance of diagnosing the source of the lesion to allow appropriate. Simon endodontic periodontal lesions present challenges to the clinician as. This post will look at the basics of these lesions and how to easily classify, diagnose and manage them. Endo perio lesions, periodontal, pulpal, diagnosis. Periodontal management of non healing endodontic lesion nitin h. Radiographic analysis of periodontal and endodontic lesions. One frequently hears diagnoses of endo perio 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. An endo perio lesion is a condition which is characterized by the association of periodontal and pulpal disease found in the same dental element. Diagnosis and management of endodonticperiodontic lesions. In others, periodontal pathology may create pulpal pathology. The periodontal endodontic lesions have been characterized by the involvement of the pulp and periodontal disease in the same tooth. Ppt endodontic periodontal lesions powerpoint presentation. 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 endo periodontal lesions that shed light on an ambiguous pathologic situation that is often misinterpreted in clinical practice.
Hospital, long beach, california and clinical assistant professor of endodontics, university of. The simultaneous involvement of pulpal problems and inflammatory periodontal disease can complicate. The periodontium is a group of tissues that are involved with the support of the tooth. Primary periodontal lesions with secondary endodontic involvement. These types of lesions can be a devil to diagnose and treat successfully.
Endo perio lesions might be interdependent because of the vascular and anatomic connections between the pulp and the periodontium. Management of endodonticperiodontic lesions springerlink. Divya bhat abstract an endo perio lesion has been one of the most common problems associated with the tooth. The longterm prognosis after treatment of perio endo lesions is determined by correct primary diagnosis and careful endodontic treatment, followed by periodontal treatment if necessary. Review periodontal management of non healing endodontic lesion. The prognosis of periodontal lesions is poorer than endodontic lesions and is dependant on the apical extension of the lesion. The main objective of this paper was to report the clinical effectiveness of leukocyte platelet rich fibrin lprf in the treatment of a combined endo periodontal lesion of an. An endo perio lesion can have a varied pathogenesis which ranges from simple to relatively complex one. However, prognosis of primary periodontal lesions is not as favorable as primary endodontic lesions.
Treat initially as primary endo with secondary perio lesion the prognosis is often poor or even hopeless, especially when periodontal lesions are chronic, with extensive loss of attachment. Jun 20, 2014 endo perio lesions might be interdependent because of the vascular and anatomic connections between the pulp and the periodontium. 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. Figure 1 list of acute periodontal conditions, according to di. You have remained in right site to begin getting this info. Periodontal regenerative therapy in endoperiodontal. These are quite rare and may be caused in 3 main ways. Of endodontic origin lesion definition of of endodontic.
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