Updated : Jul 20, 2021 in Literature


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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Endo-Perio Dilemma: A Brief Review

The interrelationship between periodontal and endodontic disease has always aroused confusion, queries, and controversy. The overfilling of root canals produces a lesion in exactly the same way as the lesion originating adjacent to the apical foramen rather than the lateral wall or pulpal floor.

Development of a classification system for periodontal diseases and conditions. Aust Dent J ; It therefore must always be accompanied by additional tests.

Diagnosis and treatment of endodontically treated teeth with vertical root fracture: This is predominantly a mixed anaerobic infection. It could be of two subcategories. The tooth has a pulpless, infected root canal system and a coexisting periodontal defect.

Moreover, the dentinal fluids move towards the exterior, thereby reducing the diffusion of the harmful products of the bacteria on the exposed dentin. The density and branching of dentinal tubules in human teeth. Therefore, to achieve the best outcome for these lesions, a multi-disciplinary approach should be involved.


The pathways for the spread of bacteria between pulpal and periodontal tissues are still a subject of controversy [ 2 — 6 ]. Discussion It is known that both the pulp and the periodontium are closely linked to each other, through the apical foramen, accessory canals, and dentinal tubules of the root, pwrio one can interfere on the integrity of the other.

International Journal of Dentistry

Replacement resorption ebdo ankylosis occurs following extensive necrosis of the periodontal ligament with formation of bone onto a denuded area of the root surface. The canals are eventually filled with a conventional obturation when there is clinical evidence of improvement.

Classification and clinical indications. Indian J Dent Res ; Carious lesions or any direct exposure to the oral cavity of dentine or pulp may ingress bacteria to contaminate an otherwise sterile lesion.

Simring M, Goldberg M.

Endo-Perio Dilemma: A Brief Review

The pulp subsequently becomes necrotic and infected. Int J Paediatr Dent ; An evaluation of endodontically treated vertically fractured teeth.

The actual relationship between periodontal and pulpal disease was first described by Simring and Goldberg in In addition, radiographs are of utmost importance for documentation and legal purposes.

Indexed in Web of Science. Madison S, Wilcox LR. Microleakage–full crowns and the dental pulp. The antibacterial effect of calcium hydroxide and chlorhexidine on Enterococcus faecalis. An evaluation of coronal microleakage in endodontically treated teeth.


A New Classification of Endodontic-Periodontal Lesions

Ray and Trope [ 14 ] reported that defective restorations and adequate root canal fillings had a higher incidence of failures than teeth with inadequate root canal fillings and adequate restorations. Some periodontal lesions of endodontic origin can heal following root canal treatment alone. Int Endod J ; Determining the prognosis depends upon the stage of periodontal disease and the efficacy of periodontal treatment.

Rotstein I, Simon JH. Mild pain or discomfort and swelling are the major clinical symptoms, and solitary pocket around one aspect of the suspected tooth is the major clinical sign. Dazey S, Senia ES.

After 20 weeks, marginal epithelial downgrowth was found on the denuded dentin surface of the infected teeth. Etiologic factors such as bacteria, fungi, and viruses as well as various contributing factors such as trauma, root resorptions, perforations, and dental malformations play an important role in the development and progression of such lesions.

The pulp and periodontium have embryonic, anatomic and functional inter-relationships.