Endo-periodontal Lesions Research Articles

Possibilities of endodontic therapy of endodonic-periodontal lesions

Endoperiodontal lesions are frequent in clinical practice and may require complex therapy. It is very important to determine differential diagnosis and the origin of the lesion, because the treatment plan is based on aetiology and stadium of the development of the lesion. The aim of this clinical study was to analyze the efficacy of endodontic treatment in different types of endodontic-periodontal lesions. Thirty patients and 42 teeth with diagnosed endoperiodontal lesions were included in the study and divided in two groups. Vital pulp therapy was applied to 18 vital teeth where the diagnosis was perio-endodontic lesions. The therapy of infected canal system was applied to 24 teeth with endodontic-periodontal or combined lesions. Standard endodontic procedure consisted of cleaning and shaping of the root canal system and between sessions filling with calcium-hydroxide paste. Obturation was made by lateral compact of the guttapercha and Apexit paste. Efficiency was evaluated clinically and radiographically three, six and twelve months later. Radiographic and clinical follow-up showed a significant radiographic improvement and absence of subjective symptoms in a very high percentage of the treated vital and avital teeth. The results of this study showed that in the observation period of 12 months endodontic therapy was successful in 88.89% of vital teeth, and in the group of avital teeth the percentage was 91.67%. Endodontic treatment of the endoperiodontal lesions was sufficient and it was the basic condition to achieve a complete healing of endodontic-periodontal lesions. Such therapy ensures significant improvement or even complete healing of both types of lesions, of endodontic and periodontal origin.

Classification des maladies parodontales

Periodontal diseases are multifactor disorders (numerous modifying and aggravating factors), difficult to diagnose without the help of a classification that allows comparing the patient’s data to those scientific and epidemiologic data recently published. Such diagnosis implies a therapeutic strategy, and a prognosis adapted to each clinical case, taking into account the anamnesis and the result of the clinical examination. A new easier and more clinical classification of these periodontal diseases, based on the advances in scientific knowledge and on the epidemiological data of the past ten years, has been proposed in 1999 during a worldwide consensus conference. Gingivitis, a specific disease of the superficial periodontal tissue, is largely described. Periodontitis which affects deep periodontal tissues may be identified as chronic periodontitis, or aggressive periodontitis, or as a manifestation of a systemic disease. New entities appear, such as the necrotizing periodontal diseases, the endoperiodontal lesions, and the occlusive trauma. Early periodontal diseases, due to their excessive dependence on the age, and persistent periodontitis, because of the heterogeneity of this group (recurrences, resistant diseases) have been suppressed from this new classification.

Resolution of furcation bone loss after non-surgical root canal treatment: application of a peptidase-detection kit for treatment of type I endoperiodontal lesion

Here, we report the management of a type I endoperiodontal lesion with furcation bone loss. A 59-year-old female attended our hospital with the chief complaint of mobility of tooth 46 and recurrent gingival swelling around the tooth. She previously received dental treatment from two dentists, but her condition did not improve. The tooth manifested the symptoms of typical periodontitis, such as gingival swelling, tooth mobility, pus discharge from the periodontal pocket and furcation bone loss. The tooth had no caries and the pulp reacted to an electric pulp test. Careful examination of the gingiva revealed traces of dental fistula. X-ray examination via a gutta percha inserted into the fistula revealed that furcation bone loss was associated with the periapical lesion. We diagnosed a type I endoperiodontal lesion, and applied Periocheck, a detection kit for peptidase-producing bacteria, to check for decreases in bacteria in the furcation and root canals. Soon after non-surgical root canal treatment, the condition of tooth 46 improved without periodontal treatment. After confirming a negative score with Periocheck, the root canal was filled. After 3 months, the furcation bone loss was on the way to recovery. These results indicate that proper diagnosis and confirmation of a decrease in root canal bacteria are important for treating endoperiodontal lesions.

Possibility of usage of a homeopathic remedy heparsulfuris in the therapy of endoperiodontal lesion

The aim of this paper was to, on the basis of everyday clinical practice analize the effect of a homeopathic remedy, as a complementary remedy in endodontic therapy of endoperiodontal lesions and chronic apical periodontitis and to radiologically check its effect on the flow and speed of reparation of damaged periodontal tissues. Endodontic therapy was done according to the usual protocol for the therapy of infectious canals with root canal preparation, medication with calcium hydroxide points and hermetic obturation with AH-26 paste. During endodontic treatment patients were taking homeophatic remedy Hepar sulfuris per os three times daily. The remedy stimulates the natural defences mechanism of the organism. Radiological follow up after three months period showed obvious reductiont of radiologic radiolucency in periapical region.