Endo lesions

Question 1

● **determining 1’ source is not relevant for tx as both RCT & perio tissues require tx

Answer 1

o Endo is usually done first
o Perio therapy follows endo
o Root resection or hemisection may be viable alternative

Question 2

● Physical Routes of Communication

Answer 2

o Apical Foramen
o Lateral (Accessory) Canals
▪ Kirkham found 28% & Rubach found 45% on single rooted teeth (apical 1/3 of tooth)
▪ Gutman found 28% in molar furcations
o Dentinal Tubules (controversial)
▪ Seltzer found 21% incidence of inflammation in pulp & periodontium
▪ Adriaens demonstrated bacteria in dentinal tubules (false positives in controls may indicate contamination)
o Iatrogenic
▪ Something the dentist has caused
▪ Soft tissue will not attach to amalgam, but will attach to MTA or glass ionomer

Question 3

● Healing Potential

Answer 3

o Osseous lesions of endo origin can be expected to heal completely
o Osseous lesions of perio origin are usually not reversible & depend on defect morphology for regeneration
o **The greater the perio involvement, the worse the prognosis

Question 4

● Diff Dx:

Answer 4

incomplete tooth fracture, developmental grooves, CEPs, periodontal abscess

Question 5

Root planning

Answer 5

– removing the endotoxin