periodontitis associated with endodontic lesions

Periodontitis Associated with Endodontic Lesions

[object Object],[object Object],Periodontic-Endodontic Lesions

[object Object],Periodontic-Endodontic Lesions

Anatomical Pathways Connecting Endodontic & Periodontal Tissues ,[object Object],[object Object],[object Object],[object Object]

8.8 % 1.6 % 17 % Frequency of Accessory Canals ,[object Object],[object Object],De Deus, 1975

Accessory Canals ,[object Object],[object Object],bacterial byproducts that could reach the periodontium through accessory canals.

Dentinal Tubules ,[object Object],[object Object]

Dentinal Tubules Vs. Accessory Canals Dentinal Tubules Accessory Canal

[object Object],[object Object],Simon et al (1972) Classification

Simon et al (1972) Endodontic lesions with secondary periodontic involvement COMBINED LESIONS (“True” combined lesions) ENDODONTIC LESIONS PERIODONTIC LESIONS Periodontic lesions with secondary endodontic involvement

Primary Endodontic Lesion ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Drainage of endodontic abscess into the sulcus follows one or two routes: Extraosseous fistulation Periodontal ligament fistulation

Effect of Pulpal Disease on the Periodontium ,[object Object],[object Object]

Periodontal ligament Fistulation

Primary Endodontic Lesion w/Secondary Periodontal Involvement ,[object Object]

Calculus If this lesion was considered for endodontic treatment – it is necessary to complete “closed” root planing if there is to be any osseous regeneration

Retrograde Periodontitis ,[object Object]

Primary Periodontal Lesion ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Primary Periodontic Lesion w/Secondary Endodontic Involvement ,[object Object],[object Object]

Primary Perio Lesion W/ Secondary Pulpal Disease

“ True” Combined Lesions ,[object Object],[object Object],[object Object]

Pathogenesis Pulpal disease Periodontal disease SHARED ETIOLOGY Microbiologic Immunologic

Microbiology ,[object Object],SPIROCHETES Fusobacterium Prevotella Porphyromonas Peptostreptococcus Eubacterium Capnocytophaga Lactobacillus

Microbiology ,[object Object],[object Object]

[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Predisposing Factors that Contribute to Endo- Perio Lesions

Palato-Gingival Grooves ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Kogan,1986

Trauma-Induced Root Resorption ,[object Object],[object Object],[object Object],[object Object]

Cracked Tooth ,[object Object],[object Object]

Vertical Root Fracture ,[object Object],[object Object]

Root Perforations ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Endodontic Therapy ,[object Object],[object Object]

Effects of Periodontal Disease on the Pulp ,[object Object],[object Object],[object Object],[object Object],[object Object]

Effect of Perio Tx on the Pulp ,[object Object],[object Object],*Bergenholtz and Lindhe,1978 **Mazur and Massler, 1964 Czarnecki and Schilder, 1979 Torabinejad and Kiger,1985

Effect of Endo Tx on the Periodontium ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Diagnostic Considerations ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Treatment ,[object Object],[object Object]

[object Object],[object Object],[object Object],[object Object],[object Object],Treatment

Endodontic Lesion ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Endodontic Lesion with secondary Periodontal disease ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Periodontal lesion ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Periodontal Lesion with secondary Endodontic disease ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Combined Lesion ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

periodontitis associated with endodontic lesions

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periodontitis associated with endodontic lesions

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