Multidisciplinary Approach to the Conservative and Regenerative Management of Endo-Perio Lesion

Abstract

This case report evaluates the clinical and radiographic response of biphasic calcium phosphate (ossify) when used in combination with bioresorbable membrane (sybograft - GBR) for the treatment of intrabony defect around multi-rooted teeth with an endodontic and periodontal lesion. A 47-year-old female patient with an endo-perio lesion in the left mandibular first molar was initially treated with endodontic therapy. After endontic management of the teeth a full-thickness flap reflected, complete degranulation and root planing was performed. An allograft was then used to fill the defect and a GBR membrane was placed over the filled defect. Radiographs, clinical probing depths, and attachment levels were obtained before treatment, 3, 6, 9 and 24 months following treatment. Reduction in pocket depth and gain in clinical attachment level were observed during follow up. This case report demonstrates that proper diagnosis, followed by removal of etiological factors and utilizing the guided tissue regeneration technique combined with osseous grafting, will restore health and function of a tooth with severe bone loss caused by an endo-perio lesion. This report highlights a conservative and regenerative approach to the management of endo-perio lesion rather than a radical approach such as hemisection.