Skuteczne leczenie zębów z różnymi rodzajami zmian endo-perio
Successful management of teeth with different types of endodontic-periodontal lesions
An endodontic-periodontal lesion consists of concurrent pulpal and periodontal disease in the same tooth. The spread of infection between the dental pulp and the periodontal ligament can occur through the apical foramen, lateral canals, dentinal tubules, and palatogingival grooves. Moreover, nonanatomic factors can have a role in this communication such as iatrogenic root canal perforations or a vertical root fracture. These pathways cause the spread of infection and bone destruction in a coronal-to-apical direction in the case of periodontal infection or in an apical-to-coronal direction in the case of endodontic infection [1].
In 1964, Simring and Goldberg [2] were the first to describe the relationship between pulpal and periodontal disease and referred to it as an „endo-perio lesion.” The most common classifications of endodontic-periodontal lesions were primary endodontic disease, primary periodontal disease, and combined disease, depending on the cause of the lesion [3]. In 2014, Al-Fouzan [4] suggested a new endodontic-periodontal interrelationship classification, based on the primary disease and its secondary effect. The classification is as follows:
- Retrograde periodontal disease:
a) primary endodontic lesion with drainage through the periodontal ligament,
b) primary endodontic lesion with secondary periodontal involvement. - Primary periodontal lesion.
- Primary periodontal lesion with secondary endodontic involvement.
- Combined endodontic-periodontal lesion.
- Iatrogenic periodontal lesion.
This rational classification increases the [...]
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