A case series associated with different kinds of endoperio. Apical progression of perio disease can open and expose the pulp to the oral environment by lateral canals or dentinal tubules a tooth with perio disease that does not respond to perio treatment alone may have a diseased pulp when the pulp becomes necrotic. Radiographic and clinical diagnosis helps in clarifying the nature of the problem. Autoplay when autoplay is enabled, a suggested video will automatically play next. Endo perio lesions might be interdependent because of the vascular and anatomic connections between the pulp and the periodontium. This lesion is caused by a dentalrelated abscess, which has perforated alveolar bone and formed a path of drainage. Management of failed periodontal surgical intervention for a. A sequential approach in treatment of endo perio lesion a case report. The simultaneous involvement of pulpal problems and inflammatory periodontal disease can complicate. This sets off whats called an inflammatory response because the body sees the debris as a foreign invader. Pre treatment clinical and radiographic view post treatment clinical and radiographic view fig 3.
Periodontal endodontic lesions objectives introduction d. D between lesions of periodontal origin and endodontic origin. One frequently hears diagnoses of endoperio lesions when in fact there is an endodontic lesion mimicking periodontal disease or, vice versa, a purely periodontal lesion perfectly is camouflaged as an endodontic pathology. The primary endodontic lesion with a secondary periodontal involvement first requires an endodontic therapy and, in the second stage, a periodontal therapy. Case report fibrous epulis misdiagnosed for combined periodonticendodontic lesion khzam 1n, shah mansouri r2, poli a3, bakr mm4 abstract fibrous epulis or peripheral ossifying fibroma is a reactive nonneoplastic condition that affects the gingiva as a result of chronic irritation.
The aim of this study is to emphasise that primary endodontic lesion heals after a proper instrumentation, disinfection and sealing of the endodontic space. The apical foramen is the main access route between the pulp and the periodontium, with the. Management of endoperio lesions have always been a dilemma to the dental. Generally, in a case of combined endoperio lesion, an adequate endodontic therapy would result in healing of the endodontic component, and the prognosis would finally depend on the efficacy of periodontal repairregeneration initiated by either of the treatment procedures. Endoperio lesions might be interdependent because of the vascular and anatomic connections between the pulp and the periodontium.
Elimination of the focus of infection through incisional drainage, root canal therapy, or tooth extraction. The periodontium includes the gingiva,cementum, periodontal ligament pdl. The most conventional classification used for endodonticperiodontal lesions was given by simon et al. Endodonticperiodontal lesions present challenges to the clinician as far as diagnosis and prognosis of the involved teeth are concerned. The subject of combined endo perio lesions is surrounded by considerable confusion. The nature of that pain is often the first clue in determining the etiology of such a problem. The health of the periodontium is importantto the proper function of a tooth.
Whereas the endoperio lesion will often produce resolution of the joint problem with endodontic treatment alone, the perioendo lesion will still require periodontal treatment and even then the prognosis is far poorer. The lesion may remain small or it can expand to destroy the attachment of the tooth and communicate with a lesion of periodontitis. Of periodontolgy,gitam dental college and hospital 3. To critically evaluate the existing literature on acute lesions occurring in the periodontium periodontal abscesses pa, necrotizing periodontal diseases npd, and endo. A symptomatic tooth may have pain of periodontal andor pulpal origin. The culprit of this type of histologically diagnosed lesion is the occlusal traumatism glossary of periodontal terms, 2001 or traumatogenic occlusion. Disease that affects the periodontium usuallyis a result of the direct extension of pulpaldisease or due to apical progression ofperiodontal disease.
This article is an attempt to provide a rational approach to the endoperio question in order to treat these lesions with predictable success. The nature of pain for that symptomatic tooth helps in determining the etiology of such a problem. A symptomatic tooth may have pain of periodontal or pulpal origin. Endo perio lesions are occasionally encountered complicated dental conditions, difficult to diagnose and treat. Please use the wrist strap to help prevent injury to other people or damage to. Endoperio lesions primarily occur by way of the intimate anatomic and vascular connections between the pulp and the periodontium. 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. If we were to look at endo perio lesions that began from the endodontic tissue, there are a number of potential causes. A case report pradeep gade1,krishnaveni chunduru2,u. For assessing the retention rate of endodontically treated teeth, the orthograde endodontic retreatment is a predictable procedure with excellent longterm prognosis. A sequential approach in treatment of endoperio lesion a. The subject of combined endoperio lesions is surrounded by considerable confusion. Acute periodontal lesions periodontal abscesses and. A dilemma from 19 th until 21 st century abhishek parolia 1, toh choo gait 2, isabel c.
How to diagnose and treat periodontal endodontic lesions. Endoperiodontal lesion endodontic approach europe pmc. If we were to look at endoperio lesions that began from the endodontic tissue, there are a number of potential causes. A better treatment plan leads to a better result as seen in this case report. However, when the same procedure was performed on germfree rats, not only did the pulps remain vital and relatively nonin. Bradley trattner takes a conservative approach to save a tooth endodonticperiodontal lesions are complex entities that can be quite challenging.
A 50yearold female patient with uncontrolled diabetes type 2 is suffering from a purulent discharge coming from the upper right canine. Differentiating between a periodontal and an endodontic problem can be difficult. 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. Issuu is a digital publishing platform that makes it simple to publish magazines, catalogs, newspapers, books, and more online. This work is to discuss the management of an endo perio 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. This product only plays wii game discs and nintendo gamecube. Endoperio lesions after presenting this subject one should be aware of. Aug 20, 2014 endo perio lesions primarily occur by way of the intimate anatomic and vascular connections between the pulp and the periodontium. Interdisciplinary management of an endoperio lesion in a chronic. Endoperio lesions periodontology notes dentalnotebook. 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. The patient was treated only with an endodontic intervention followed by appropriate coronal sealing.
Dec 27, 2010 generally, in a case of combined endo perio lesion, an adequate endodontic therapy would result in healing of the endodontic component, and the prognosis would finally depend on the efficacy of periodontal repairregeneration initiated by either of the treatment procedures. This article is an attempt to provide a rational approach to the perio endoendo perio question in order to scientifically diagnose and treat these lesions with predictable success. A sequential approach in treatment of perioendo lesion. And the missing patterns of endo perio lesions were identified, and then. The interrelationship between periodontal and endodontic disease has always aroused confusion, queries, and controversy. The endo perio lesion may be the most complex, recalcitrant localized problem we encounter.
The most appropriate treatment of a true combined endodonticperiodontal lesion is periodontal surgical therapy before nonsurgical endodontic treatment periodontal surgical therapy only nonsurgical root canal therapy before periodontal therapy. Makes all opponents spin out, drop their items, and shrink for a brief period of time. A case series associated with different kinds of endoperio lesions. Cooperation between different disciplines that includes periodontology, endodontic and prosthodontics is required to effectively treat the lesion. One frequently hears diagnoses of endo perio lesions when in fact there is an endodontic lesion mimicking periodontal disease or, vice versa, a purely periodontal lesion perfectly is camouflaged as an endodontic pathology. As you can we have a diagnostic dilemma, if the perio endo lesion has advanced to the point that the pulp is nonvital. Dental practice education research unit a joint venture between the university of adelaide and colgate oral care provides officebased continuing dental education programs periodontal education, fluoride update and caries control which meet the information needs of dentists, dental therapists and dental hygienists and promote the provision of preventive services. Acute periodontal lesions periodontal abscesses and necrotizing. The lesion may be asymptomatic if the infection is chronic and a path of drainage is achieved.
The followup radiographs showed complete healing of the hard and soft tissue lesions. Endo perio lesion has a complex pathogenesis and requires great skill to identify and treat it. Case report fibrous epulis misdiagnosed for combined. Leakage of battery acid can cause personal injury as well as damage to your. Start and progression of periodontitis most likely involves some disruption in the balance either increase bacterial products, increase in virulence of those products, a bacterial invasion, an excessive local response in the immune mechanisms in the gingiva, or other local and systemic factors create a lesion which merges with the gingivitis.
Endodontics lecture irrigants and intracanal medicaments. A new classification of endodonticperiodontal lesions. Do not operate the nintendo ds within 9 inches of a pacemaker while using. The periodontium includes the gingiva,cementum, periodontal ligament pdl, andalveolar bone. The complexity of endo perio lesions reflects the relevance of a close developmental. 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. The endoperio lesion may be the most complex, recalcitrant localized problem we encounter. Whereas the endo perio lesion will often produce resolution of the joint problem with endodontic treatment alone, the perio endo lesion will still require periodontal treatment and even then the prognosis is far poorer. Primary endodontic lesion with secondary periodontal involvement 4.
As you can we have a diagnostic dilemma, if the perioendo lesion has advanced to the point that the pulp is nonvital. Apical lesion with the concomitant marginal involvement also referred as a combined periodontal endodontic lesion, with great. An endo perio lesion can have a varied pathogenesis which ranges from simple to relatively complex one. 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. Apical progression of perio disease can open and expose the pulp to the oral environment by lateral canals or dentinal tubules a tooth with perio disease that does not respond to perio treatment alone may have a diseased pulp when the pulp becomes necrotic, it may contribute to the persistence of the perio lesion. A sequential approach in treatment of endoperio lesion a case report. Endodonticperiodontal combined lesion is a clinical dilemma because making a differential diagnosis and deciding a prognosis are difficult. 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. A vertical root fracture is defined as a fracture of the root that is longitudinally oriented at a more or less oblique.
An endo perio legion can have a varied pathogenesis which ranges from quito simple to rolutively complex. Abstract objective to critically evaluate the existing literature on acute lesions occurring in the periodontium periodontal abscesses pa. The tooth with endoperio lesions should be evaluated thoroughly in terms of any cracks. The resulting lesion may be an acute apical lesion, or abscess, a more chronic periradicular lesion cyst or granuloma, or lesion associated with a lateral or accesory canals.
This article is an attempt to provide a rational approach to the perioendoendoperio question in order to scientifically diagnose and treat these lesions with predictable success. A free powerpoint ppt presentation displayed as a flash slide show on id. Aug 10, 20 issuu is a digital publishing platform that makes it simple to publish magazines, catalogs, newspapers, books, and more online. An endoperio legion can have a varied pathogenesis which ranges from quito simple to rolutively complex. The complexity of endoperio lesions reflects the relevance of a close developmental. Easily share your publications and get them in front of issuus.
Simon endodonticperiodontal lesions present challenges to the clinician as far as diagnosis and prognosis of the involved. Ppt endodontic periodontal lesions powerpoint presentation. Occlusal trauma will arise when the occlusal load is sufficiently high that the periodontium cannot withstand and distribute the force without unaltered position and stability of the involved. The tooth with endo perio lesions should be evaluated thoroughly in terms of any cracks. The main objective of this paper was to report the clinical effectiveness of leukocyte platelet rich fibrin lprf in the treatment of a combined endo periodontal lesion of an. Accessory canals may not be big enough to allow bacterial penetration, periodontal disease must reach the apex to induce an endodontic lesion. For differential diagnosis and treatment purposes, endo perio lesions are classified as either. 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 case report brings to light that there can be a simple solution to a grave looking problem. The nintendo gamecube wavebird wireless controller allows you to play games.
A diagram that summarises lesion development the relationships between them. In this case report, different kinds of endoperio lesion were treated with sequential endodontic and periodontal treatment. In some cases, the influence of pulpal pathology may create periodontal involvement. Divya bhat abstract an endo perio lesion has been one of the most common problems associated with the tooth. Simon endodonticperiodontal lesions present challenges to the clinician as. Endo perio lesions by ijstr research publications issuu. And the missing patterns of endoperio lesions were identified, and then. The study demonstrated that without bacteria and their products, periapical lesions of endodontic origin do not occur. A sequential approach in treatment of endoperio lesion a case. Common benign dental and periodontal lesions intechopen. In this case report, different kinds of endo perio lesion were treated with sequential endodontic and periodontal treatment.
185 263 1111 824 14 413 153 410 464 463 384 1194 1027 600 1155 790 1457 205 1494 1570 1365 149 822 4 487 359 1152 814 903 928 233 1487 1342 714 988 23