Combined periodontic-endodontic lesions

Combined periodontic-endodontic lesions are a complex dental condition where both the periodontium and the endodontium are affected. These lesions are characterized by simultaneous periodontal and endodontic diseases with a common path of infection.

Etiology

The etiology of combined periodontic-endodontic lesions is multifactorial. The primary cause is bacterial infection, which can originate from the dental pulp (endodontic origin) or from the periodontal pocket (periodontal origin). Other factors such as trauma, root fractures, and iatrogenic factors can also contribute to the development of these lesions.

Pathogenesis

The pathogenesis of combined periodontic-endodontic lesions involves the spread of infection from one region to another through various pathways. In cases of endodontic origin, the infection can spread from the root canal to the periodontal ligament through accessory canals or apical foramen. Conversely, in cases of periodontal origin, the infection can spread from the periodontal pocket to the pulp through dentinal tubules or periodontal ligament.

Clinical Features

Clinically, combined periodontic-endodontic lesions present as a deep periodontal pocket with associated endodontic symptoms such as pain on percussion, prolonged sensitivity to heat or cold, and discoloration of the tooth. Radiographically, there may be evidence of bone loss around the tooth root and widening of the periodontal ligament space.

Treatment

The treatment of combined periodontic-endodontic lesions involves addressing both the periodontal and endodontic components. This may include root canal treatment, periodontal therapy such as scaling and root planing, and in severe cases, surgical intervention. The prognosis depends on the severity of the lesion and the response to treatment.

See Also

• Periodontitis
• Endodontic therapy
• Root canal

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