ENDOPERIO Lesions

8/3/2019 ENDOPERIO Lesions

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DR. ADIL IQBALBDS

House Surgeon

Hamdard Hniversity Hental Hospital


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Aim OF PRESENTATION:

Discuss relation between endodontic andperiodontic diseases.

Biological and clinical evidence of diagnosis

Decision making in the treatment


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Dentinal tubules

Lateral and accessory canals

Apical foramen


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minimal inflammatoryresponse..extensive destruction.

Sinus tract irrigants ,sealers and ICM.


5/19

TWO schools of thaught:

1)no major effect

2)effect is degenerative causing increase in

calcification, fibrosis, and direct inflammatorysequlae.

Periodontitis patients are threefold times more

prone. Accessory and lateral canals


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Primary endodontic

Primary periodontal

Primary endodontic with secondray

periodontal

Primary periodontal with secondraryendodontic

True combined


8/19

Deep solitary pocket in absence of periodontaldisease

Drainage thru PDL to gingival sulcus

Diagnosisradiograph with GP

Radiographically wide PDL space andperiapical radiolucency

Pulp test abnormal or absent Narrow pocket

Prognosisusually heal after RCT.


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Clinically chronic marginal periodontitis,plaque accumulation and deposits of plaqueand calculus.

Wider pockets Bony lesions associated with angular bone loss

extending from cervical lesion towards theapex. Lesion also involves adjacent tooth

Normal pulp test. Wider pockets

Prognosis on stage of periodontic diease.


12/19

A primary periolesion wronglydiagnosed andtreated as endolesion. Treatment

was failure andtooth lost.


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14/19

No treatment of primary endodontic disease forlong period of time

Clear widening of pdl space extending from apicalto cervical.

Pulp test is usually absence of response.

On probing solitary wider pocket extendingtoward the apex.

Both endodontic and periodontal treatmentsrequired and prognosis depends on severity ofmarginal periodontal damage and efficacy ofperiodontal treatments.


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Chronic marginal periodontitis

Radiographically bone loss from cervicalregion towards the apex and usually not

limitted to just single tooth. Apical radiolucency

Symptoms of pain inflammed pulp at early

stage but later on pulp becomes unresponsive. Poor prognosis in single rooted teeth.


17/19

Lesion present on both sides May or may not join depending on stage of

disease

Extensive radiolucencies of both origin

Unresponsive pulp

Wider pockets

Prognosis is usually guarded.

Longitudinal root fractures mimic the sameradiographic picture


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ENDOPERIO Lesions