EP-6 - Endodontic and Periodontic Dilemmas

The pulp and periodontium have embryonic, anatomic and functional inter-relationships. The simultaneous existence of combined endodontic-periodontal lesions either with or without root damage is a clinical dilemma that can complicate diagnosis, prognosis and treatment planning. These lesions should be classified according to signs and symptoms that have direct impact on their treatment, such as presence or absence of fractures, perforations and external root resorption, presence or absence of periodontitis, and the extent of periodontal destruction around the affected teeth. Management of combined endodontic-periodontal lesions can be challenging especially when severe destruction of the surrounding periodontal tissues is noted. Exposing a CBCT scan may be an important diagnostic tool to confirm the real extent of both lesions and their possible communication and reveal root anatomic factors that may predispose to the clinical outcome. Understanding the complex pathogenesis of both lesions can determine the therapeutic approach for a successful regenerative treatment outcome.