Endo Perio Lesion Flashcards
In endo perio lesions 3 main communications are?
1.Apical foramen
2.Lateral and accessory canals
3.Dentinal tubules
It is the principal and the most direct route of communication between the pulp and periodontium
Apical foramen
Additional communication between the Pulp and the Periodontium?
1.Vertical root fracture
2. Perforations
These may result from extensive carious lesions, resorption, or from operator error?
Perforations
Major causes of pulpal inflammation are
1.Instrumentation (during
periodontal,restorative,or prosthetic
dentistry).
2.Dental caries.
3.Direct trauma (Tooth fracture).
whats Classification of pulpal disease?
Reversible pulpitis
Irreversible pulpitis
Hyperplastic Pulpitis
Pulpal necrosis
T/F As long as pulp is vital there is no effect on periodontium.
T
EXPLAIN the Effect of pulpitis on periodontium?
Pulp necrosis, bone resorption,periapical radiolucency or at furcation or at along roots, acute apical lesion or abscess. More chronic periradicular lesion cyst or granuloma formed, that loss attachment of tooth and effect on periodontium tissues.
Effect of periodontitis on the Dental pulp
Retrograde pulpitis
t/f Pulp has very good defense capacity, as long as blood supply through the apical foramina is intact
t
classification system was developed by Simon, Glick and Frank in 1972 for endo perio lesions was?
Primary Endodontic Disease
Primary Periodontal Disease
Primary Endo w/ Secondary Perio
Primary Perio w/ Secondary Endo
True Combined Lesions
Pulp tests yield a clinically normal pulpal reaction in primary periodontal disease T/F
T
A periapical lesion of endodontic origin will not occur in the presence of a normal vital pulp!!!
T/F
T
Primary Endo with Secondary Periodontal DISEASE what should be done first?
Endodontic treatment
The progression of periodontitis by way of lateral canal and apex to induce a secondary endodontic lesion
is called?
Primary perio and secondary endo disease
In single-rooted teeth the prognosis is
usually poor, as the periodontal breakdown is very severe, necessitating extraction
In teeth the prognosis may be better, since not all the roots may suffer the same loss of supporting periodontium. Root resection may be considered as a treatment alternative
molar
HOW , the treatment of periodontal disease can also lead to secondary endodontic involvement
Lateral canals and dentinal tubules may be opened to the oral environment by scaling and root planing or surgical flap procedures
T/F True combined endo/perio disease occurs MORE frequently than other endo/perio problems
F
Identify the lesion Radiograph shows bone loss in 2/3 of the root with calculus present and a separate periapical radiolucency. Clinical exam revealed coronal color change and pus exuding from the gingival crevice. Pulp vitality tests were negative
True combined lesions
for the diagnoses of true combined lesions Data Collected must include:
periapical radiographs
pulp vitality testing: cold, thermal, cavity test
percussion
palpation
pocket probing
sinus tract tracking
cracked tooth testing
Primary endo should only be treated by ……. and has a good prognosis
endodontic treatment
Primary perio should only be treated by ……. The prognosis depends on severity of the perio disease and patient response to treatment
periodontal treatment
In primary endo the pulp is nonvital. In primary perio the pulp is
vital
explain Rx of Periodontal disease with secondary pulpal involvement
Check the state of pulp
If Necrosis first do RCT.
If pulp is vital than Perio treatment should be performed first to see whether the reduction in the source of irritaion will lead to pulpal recovery.
T/F Combined lesions should be treated with endodontic therapy first
T
In combined lesion periodontal treatment be considered after how much time of endodontic treatment
2-3 months
This sequence allows for sufficient time for initial tissue healing and better assessment of the periodontal condition to determine if the tooth needs surgical treatment.
