Endo perio lesions present challenges to the clinicians in their proper diagnosis, apt treatment and prognosis of the involved teeth. A new classification of endodonticperiodontal lesions. The success of a combined periodontal and endodontic lesion depends on the elimination of both of these disease processes. Radiographic and clinical diagnosis helps in clarifying the nature of the problem. Among these conditions, the following diseases have been listed. Endo perio lesions by ijstr research publications issuu.
Terminology is always a difficult thing in dentistry, and endoperio lesions can lead to some confusion. 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. Endoperio lesions might be interdependent because of the vascular and anatomic connections between the pulp and the periodontium. A sequential approach in treatment of perioendo lesion sumit narang 1, anu narang 2, ruby gupta 1. A symptomatic tooth may have pain of periodontal andor pulpal origin. The periodontium includes the gingiva,cementum, periodontal ligament pdl, andalveolar bone. The health of the periodontium is importantto the proper function of a tooth. In the case of a combined endoperio 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. In others, periodontal pathology may create pulpal pathology. 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. The best guide i have for differentiating the two is the fact that periodontal lesions generally are not present around a single tooth.
Endoperio lesions after presenting this subject one should be aware of. Root amputation, hemisection or bicuspidization maybe done to save part of. Treatment of periodontalendodontic lesions in cases of true combined lesions. A read is counted each time someone views a publication summary such as the title, abstract, and list of authors, clicks on a figure, or views or downloads the fulltext. Learn dental endo and perio with free interactive flashcards. The interrelationship between periodontal and endodontic disease has always aroused confusion, queries, and controversy. Careful diagnosis is required followed by a detailed discussion with the patient so. The nature of pain for that symptomatic tooth helps in determining the etiology of such a problem. 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. If we were to look at endo perio lesions that began from the endodontic tissue, there are a number of potential causes.
It is difficult to differentiate it from the endoperio lesion. This occurs as a result of the similarity of their signs and symptoms, given that both diseases and their. 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. These types of lesions can be a devil to diagnose and treat successfully. This post will look at the basics of these lesions and how to easily classify, diagnose and manage them. Pdf periodontal aspects of endodonticperiodontal lesions. Disease that affects the periodontium usuallyis a result of the direct extension of pulpaldisease or due to apical progression ofperiodontal disease. Periodontalendodontic lesions are often changes that affect all teeth due to the close. 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. Choose from 500 different sets of dental endo and perio flashcards on quizlet. Acute periodontal lesions periodontal abscesses and.
A sequential approach in treatment of perioendo lesion. A diagram that summarises lesion development the relationships between them. The aim of this study is to emphasise that primary endodontic lesion heals after a proper instrumentation, disinfection and sealing of the endodontic space. Issuu is a digital publishing platform that makes it simple to publish magazines, catalogs, newspapers, books, and more online. Syed wali peeran, madhumala thiruneervannan, khaled awidat abdalla, marei hamed mugrabi. In their, 2006 endodontic practice paper, titled endodontic management of the endodonticperiodontal lesion, jorge vera, martin trope, frederic barnett and kenneth s serota demonstrated that. In some cases, the influence of pulpal pathology may create periodontal involvement. Etiologic factors, such as bacteria and viruses, as well as contributing. How to diagnose and treat periodontal endodontic lesions. However, once the pulp became infected, periapical lesions and in. 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. Supported by a thorough analysis of the diagnostic, etiopathogenic, and clinical factors, the author of this succinct book proposes new terminology and a simplified. This work is to discuss the management of an endoperio lesion, which represents a challenge to clinicians when it comes to diagnosis and prognosis of the involved teeth and especially with an altered general condition.
A 56yearold male patient with an endoperio lesion in the right mandibular. Simring and goldberg described the relation between pulpal and periodontal disease in 1964simring m et al,1964. Hears diagnoses of endoperio lesions when in fact there is an endodontic. Simon endodonticperiodontal lesions present challenges to the clinician as.
The subject of combined endoperio lesions is surrounded by considerable. A free powerpoint ppt presentation displayed as a flash slide show on id. Endoperiodontal lesion endodontic approach europe pmc. Successful endodontic treatment is based not only on the absence of periapical pathology but upon the longterm retention and function of the treated tooth. A case report pradeep gade1,krishnaveni chunduru2,u. An endo perio lesion can have a varied pathogenesis which ranges from simple to relatively complex one. The apical foramen is the main access route between the pulp and the periodontium, with the. An endodontic lesion usually involves an irreversibly inflamed or necrotic dead pulp. A dilemma from 19 th until 21 st century abhishek parolia 1, toh choo gait 2, isabel c. Perio endo lesion pdf consequences of periodontalendodontic lesions, as well as its clinical. Divya bhat abstract an endo perio lesion has been one of the most common problems associated with the tooth. Endodontic periodontal lesions are complicated disease entity, frequently encountered in daytoday dental practice, difficult to diagnose and treat. Differentiating between a periodontal and an endodontic problem can be difficult.
Sometimes when the pulp becomes necrotic, the infection extends beyond the root of the tooth and resorbs part of the surrounding bone. A case report syed gufran ali, mulay sanjyot, athavale uma, aggarwal shlllini an ennnprnn irsinn rwn havp n vari lesion. Endo perio lesions are occasionally encountered complicated dental conditions, difficult to diagnose and treat. They are common to the whole mouth and often exhibit similar lesions on the contralateral tooth. Easily share your publications and get them in front of issuus. Endodontic periodontal lesions present challenges to the clinician regarding diagnosis, treatment planning and prognosis. The success of management of a combined periodontal and endodontic lesion depends on the elimination of both of the disease processes.
Endodontic and periodontal lesions can manifest identical symptoms despite originating from separate pathogens, and traditional classification has reinforced etiological imprecision in both diagnosis and treatment. A 50yearold female patient with uncontrolled diabetes type 2 is suffering from a purulent discharge coming from the upper right canine. Periodontology,2000, acute,gingival,and,periodontal. 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. Needless to say, successful treatment of endoperio lesions requires successful outcomes in both the endodontic and periodontal component of treatment.
The actual relationship between periodontal and pulpal disease was first described by simring and goldberg in 1964. The prognosis of periodontal lesions is poorer than endodontic lesions and is dependant on the apical extension of the lesion. The nature of that pain is often the first clue in determining the etiology of such a problem. Endoperio lesions periodontology notes dentalnotebook. According to the american academy of periodontology, 1 acute periodontal diseases are rapid. The simultaneous involvement of pulpal problems and inflammatory periodontal disease can complicate. When a clinician cannot make a definitive diagnosis in the case of an endoperio lesions, it may be prudent for him or her to initiate either of the treatment modalities and hope for repair.
Endodontic lesions are most frequently initiated and sustained by the apical foramen, followed by accessory and lateral canals,and most infrequently by dentinal tubules. Since then, the term perioendo lesion has been used to describe lesions due to inflammatory products found in varying degrees in both the periodontium and the pulpal tissues. Endo perio lesions are a challenging condition for the dental professionals regarding the diagnosis and treatment for the same. A table summarizing the key factors of the initial, early, established and advanced periodontal lesion.
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