Endo-Perio Lesions

Question 1

What dx when infection moves from PDL to pulp?

Answer 1

Retrograde pulpitis

Question 2

What is retrograde pulpitis?

Answer 2

Pathogenic bacteria/inflammatory products of periodontal disease move via accessory/lateral canals and apical formen

Question 3

Classifications perio/endo lesions?

Answer 3

1. Primary endo secondary perio
2. Primary perio secodnary endo
3. True combined

Question 4

What is a primary endo secondary perio lesion?

Answer 4

Originally endo lesion - infection spread from apex along root to gingviae

Question 5

What is primary perio secondary endo lesion?

Answer 5

Periodontal pocket deepen to apex and involve pulp

Infect pulp via lateral canal

Question 6

What is a true combined leison

Answer 6

Two independent lesion - can co-exist, may eventually fuse

Question 7

Dx when have endo:perio lesion?

Answer 7

Hx - clinical symptoms
Exam - mobility, percussion,TTP, restorative status, periodontal
Special tests

Question 8

Manage primary endo lesion?

Answer 8

Root canal treatment - secondary perio lesion due drainage via PDL
Review 3 months w/ non-surgical perio if pocket present
Review further 3 months

Question 9

How treat primary perio and secondary endo lesion?

Answer 9

RCT and perio

Question 10

How treat true combined lesions

Answer 10

RCT and perio

Question 11

Does true perio involvement affect prognosis?

Answer 11

Depends on extent of bone loss

Question 12

What lesions can look like perio-endo lesions?

Answer 12

Developmental grooves
Perforation
Root fractures
Resoprtion

Question 13

Why can developmental grooves cause lesions?

Answer 13

Predispose formation of deep periodontal pocket - if untx can become infected

Question 14

How can perforation present?

Answer 14

Deep pockets leading to site of perforation

Bone loss around site perforation

Question 15

How manage perforation?

Answer 15

If unrestorable - XLA

Restorable - repair of perforation - internal/external using biocompatible MTA/biodentien

Question 16

Manage root fracutre?

Answer 16

Any vertical fracture onto root face = XLA

Question 17

Types of resoprtion?

Answer 17

External and internal

Question 18

Types external resoprtion?

Answer 18

External cervical

External replacement

Question 19

What is external cervical resoprtion?

Answer 19

Resoprtion start subgingivally in cervical region

Question 20

Cause of external cervical resoprtion?

Answer 20

May be associated w/ previous trauma

Question 21

Tx of external cervical resoprtion?

Answer 21

Surgical exploration followed by reapir

Endo may /may not be required depending on progression lesion

Question 22

What is external replacement resoprtion?

Answer 22

Root surface gradually replaced with bone = ankylosis

Question 23

How dx external replacement?

Answer 23

High pitched, metallic sound on percussion

Tooth non-mobile

Question 24

What is internal root resoprtion?

Answer 24

Occurs entirely within the canal system = ovoid expansion canal

Question 25

What might see clinically w/ internal root resoprtion?

Answer 25

Pink spot lesion
Tooth partially vital
Symptoms of pulpitis

Question 26

Issue w/ obturation if internal root resoprtion?

Answer 26

Unusual canal anatomy - hard