Dealing with endo-periodontal lesions is always a challenge. In the AAE's Endodontics case difficulty assessment form the combined periodontal/endodontic lesions are considered of the highest difficulty.
In their, 2006 Endodontic Practice paper, titled ''Endodontic management of the endodontic-periodontal lesion'', Jorge Vera, Martin Trope, Frederic Barnett and Kenneth S Serota demonstrated that endodontic lesions with involvement of the attachment apparatus can be successfully healed by performing adequate root canal treatment with great emphasis on disinfection of the root canal system. As stated in the abstract:
''Occasionally periradicular lesions of endodontic
origin may be radiographically indistinguishable
from periodontal disease. Infected pulpal tissue
and microbial by-products may move through
accessory and furcal canals and cause loss of
attachment in those areas. Accurate diagnosis
may be particularly difficult when a sinus tract
originating from the endodontic lesion drains
along the periodontal ligament space, giving the
appearance of periodontal disease. Thorough
diagnostic testing to confirm pulp necrosis or
periodontal disease becomes critical when
attempting to diagnose the specific disease entity
accurately and then deliver suitable treatment.''
Guess what? They were right.
I hope you will enjoy this new video!
