Abstract
The pulp and the periodontal tissue are closely related. Endo-periodontal lesions are conditions that involve challenges in diagnosis and treatment. The success of periodontal and endodontic therapies depends on the elimination of both disease processes, in pulp and periodontium. The aim of this casereport is to present a successful treatment of a lower left first molar with primary periodontal lesion with secondary endodontic involvement in a patient with advanced chronic periodontitis. It's described the diagnosis, treatment and follow-upfor 5 years.The last clinicai and radiographic findings showed a significant radiographic improvement and absence of symptoms, despite the uncertain previous prognosis. It was concluded that this type of endo-periodontal lesions can be successfullytreated, if properly approached with integration of Periodontics and Endodontics.  
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