Comparán BNM, Hernández MPD, Madrigal OC, Guízar MJM

Language: Spanish
References: 22
Page: 250-254
PDF size: 294.93 Kb.

ABSTRACT

The treatment and prognosis of endo-periodontal lesions depend on the timely and accurate diagnosis of the endodontic and/or periodontal disease. In the case of primary endodontic lesions with secondary periodontal involvement, the treatment strategy should be focused primarily on the pulp infection and the debridement and disinfection of root canals. The aim of this study is to demonstrate the repair capacity of an endo-periodontal lesion treated with nonsurgical endodontic root therapy and no subsequent periodontal treatment. The case involves a 10-year-old male patient with pulpal necrosis and apical periodontitis of tooth 46; periodontal furcation involvement was also evident. The diagnosis was a primary endodontic lesion with secondary periodontal involvement. The furcation defect healed completely within three months of non-surgical root canal treatment, a fact confirmed by X-rays and by the reduction in the probing depth in the area of the lesion. We conclude that in cases such as this, where there is primary endodontic involvement, surgical or non-surgical periodontal treatment should be considered exclusively if the periodontal lesion persists for long periods of time.

REFERENCES

1. Simring M, Goldberg M. The pulpal pocket approach: retrograde periodontitis. J Periodontol. 1964; 35: 22-48.

2. Bergenholtz G, Lindhe J. Effect of experimentally induced marginal periodontitis and periodontal scaling on the dental pulp. J Clin Periodontol. 1978; 5 (1): 59-73.

3. Chen SY, Wang HL, Glickman GN. The influence of endodontic treatment upon periodontal wound healing. J Clin Periodontol. 1997; 24: 449-456.

4. Rotstein I, Simon JH. Diagnosis, prognosis and decision making in the treatment of combined periodontal-endodontic lesions. Periodontol. 2000; 2004 (34): 165-203.

5. Simon JH, Glick DH, Frank AL. The relationship of endodontic-periodontic lesions. J Periodontol. 1972; 43: 202-208.

6. Langeland K, Rodrigues H, Dowden W. Periodontal disease bacteria, and pulpal histopathology. Oral Surg Oral Med Oral Pathol. 1974; 37: 257-270.

7. Seltzer S, Bender IB, Ziontz M. The interrelationship of pulp and periodontal disease. Oral Surg Oral Med Oral Pathol. 1963; 16: 1474-1490.

8. Rotstein I, Simon JH. The endo-perio lesion: a critical appraisal of the disease condition. Endodontic Topics. 2006; 13: 34-56.

9. Benenoti EW, Roone I, Woldrop TC. The periopulpal connection: an analysis of the periodontic-endodontic lesion. Gen Dent. 1981; 29: 515-520.

10. Bonaccorso A, Tripi T. Endo-perio lesion: diagnosis, prognosis and decision-making. ENDO. 2014; 8 (2): 105-127.

11. Zachrisson BU. Cause and prevention of injuries to teeth and supporting structures during orthodontic treatment. Am J Orthod. 1976; 69: 285-300.

12. Kim E, Song JS, Jung IY, Lee SJ, Kim S. Prospective clinical study evaluating endodontic microsurgery outcomes for cases with lesions of endodontic origin compared with cases with lesions of combined periodontal-endodontic origin. J Endod. 2008; 34: 546-551.

13. Kipioti A, Nakou M, Legakis N, Mitis F. Microbial findings of infected root canals and adjacent periodontal pockets in teeth with advanced periodontitis. Oral Surg. 1984; 58: 213-220.

14. Kobayashi T, Hayashi A, Yoshikawa R, Okuda K, Hara K. The microbial flora from root canals and periodontal pockets of non-vital teeth associated with advanced periodontitis. Int Endod J. 1990; 23: 100-106.

15. Pécora JD, Saquy PC, Sousa Neto MD, Woelfel JB. Root form and canal anatomy or mandibular first molars. Braz Dent J. 1991; 2: 87-94.

16. Jansson L, Ehnevid H, Lindskog S, Blomlöf L. Relationship between periapical and periodontal status. A clinical retrospective study. J Clin Periodontol. 1993; 20: 117-123.

17. Jansson L, Ehnevid H, Lindskog S, Blomlöf L. Radiographic attachment in periodontitis-prone teeth with endodontic infection. J Periodontol. 1993; 64: 947-953.

18. Walton RE, Pashley DH, Ogilvie AL. Histology and physiology of the dental pulp. In: Ingle IJ, ed. Endodontics. 3er ed. Philadelphia: Lea & Febiger; 1985. p. 308-338.

19. Sundqvist G. Endodontic microbiology. In: Spangberg LSW, ed. Experimental endodontics. Boca Ratón, FL: CRC Press; 1990. p. 131-153.

20. Rossman LE. Endodontic-periodontal considerations. In: Rose LF, Mealey BL, Genco RJ, Cohen DW, eds. Periodontics: medicine, surgery and implants. Philadelphia: Elsevier Mosby; 2004. p. 772-788.

21. Armitage GC. Development of a classification system for periodontal diseases and conditions. Ann Periodontol. 1999; 4: 1-6.

22. Rossman SR, Kaplowitz B, Baldinger SR. Therapy of the endodontically and periodontally involved tooth: report of a case. Oral Surg Oral Med Oral Pathol. 1960; 13: 361-367.