Endo-Perio Lesions Flashcards
What dx when infection moves from PDL to pulp?
Retrograde pulpitis
What is retrograde pulpitis?
Pathogenic bacteria/inflammatory products of periodontal disease move via accessory/lateral canals and apical formen
Classifications perio/endo lesions?
- Primary endo secondary perio
- Primary perio secodnary endo
- True combined
What is a primary endo secondary perio lesion?
Originally endo lesion - infection spread from apex along root to gingviae
What is primary perio secondary endo lesion?
Periodontal pocket deepen to apex and involve pulp
Infect pulp via lateral canal
What is a true combined leison
Two independent lesion - can co-exist, may eventually fuse
Dx when have endo:perio lesion?
Hx - clinical symptoms
Exam - mobility, percussion,TTP, restorative status, periodontal
Special tests
Manage primary endo lesion?
Root canal treatment - secondary perio lesion due drainage via PDL
Review 3 months w/ non-surgical perio if pocket present
Review further 3 months
How treat primary perio and secondary endo lesion?
RCT and perio
How treat true combined lesions
RCT and perio
Does true perio involvement affect prognosis?
Depends on extent of bone loss
What lesions can look like perio-endo lesions?
Developmental grooves
Perforation
Root fractures
Resoprtion
Why can developmental grooves cause lesions?
Predispose formation of deep periodontal pocket - if untx can become infected
How can perforation present?
Deep pockets leading to site of perforation
Bone loss around site perforation
How manage perforation?
If unrestorable - XLA
Restorable - repair of perforation - internal/external using biocompatible MTA/biodentien
Manage root fracutre?
Any vertical fracture onto root face = XLA
Types of resoprtion?
External and internal
Types external resoprtion?
External cervical
External replacement
What is external cervical resoprtion?
Resoprtion start subgingivally in cervical region
Cause of external cervical resoprtion?
May be associated w/ previous trauma
Tx of external cervical resoprtion?
Surgical exploration followed by reapir
Endo may /may not be required depending on progression lesion
What is external replacement resoprtion?
Root surface gradually replaced with bone = ankylosis
How dx external replacement?
High pitched, metallic sound on percussion
Tooth non-mobile
What is internal root resoprtion?
Occurs entirely within the canal system = ovoid expansion canal
What might see clinically w/ internal root resoprtion?
Pink spot lesion
Tooth partially vital
Symptoms of pulpitis
Issue w/ obturation if internal root resoprtion?
Unusual canal anatomy - hard
