A new classification of endodontic-periodontal lesions.

Khalid S Al-Fouzan

doi:10.1155/2014/919173

Abstract

The interrelationship between periodontal and endodontic disease has always aroused confusion, queries, and controversy. Differentiating between a periodontal and an endodontic problem can be difficult. A symptomatic tooth may have pain of periodontal and/or pulpal origin. The nature of that pain is often the first clue in determining the etiology of such a problem. Radiographic and clinical evaluation can help clarify the nature of the problem. In some cases, the influence of pulpal pathology may cause the periodontal involvement and vice versa. The simultaneous existence of pulpal problems and inflammatory periodontal disease can complicate diagnosis and treatment planning. An endo-perio lesion can have a varied pathogenesis which ranges from simple to relatively complex one. 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. This paper aims to discuss a modified clinical classification to be considered for accurately diagnosing and treating endo-perio lesion.

Highlights

The periodontal-endodontic lesions have been characterized by the involvement of the pulp and periodontal disease in the same tooth
This makes it difficult to diagnose because a single lesion may present signs of both endodontic and periodontal involvement
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, and one can interfere on the integrity of the other

Summary

Introduction

The periodontal-endodontic lesions have been characterized by the involvement of the pulp and periodontal disease in the same tooth. This makes it difficult to diagnose because a single lesion may present signs of both endodontic and periodontal involvement. There is a general agreement today that the vast majority of pulpal and periodontal lesions are the result of bacterial infection. This suggests that one disease may be the result or cause of the other or even originated from two different and independent processes which are associated with their advancement [1]. The pathways for the spread of bacteria between pulpal and periodontal tissues are still a subject of controversy [2,3,4,5,6]

Objectives

Discussion

Conclusion