1

Perio Endo Lesions

8/31/2009 Endo 13

2

Medical historySenbility testingPocket depthFurcation involvementTooth mobilityRadiograph

8/31/2009 Endo 13

3

Non vital carious toothLateral canalFurcation involvementLocal Periodontal abscessLocalized deep pocketGood periodontal conditionResolution after RCT

8/31/2009 Endo 13

4

Drain through the periodontiam Buccul abscess

8/31/2009 Endo 13

5

Drain through the furcation

8/31/2009 Endo 13

6

Non vital toothLateral canalFurcation involvementLocal Periodontal abscessLocalized deep pocketpoor periodontal conditionResolution after RCT + perio Rx

8/31/2009 Endo 13

7

Deep periodontal pocket

8/31/2009

Periodontal probe 6mm

Endo 13

8

Nonvital second premolar

8/31/2009

Lateral canal

Endo 13

98/31/2009 Endo 13

Generalized poor periodontal conditionGeneralized deep pocketGeneralized Periodontal abscessDevelopmental defectsLateral canalFurcation involvementSound vital or nonvital toothResolution after perio Rx + RCT

8/31/2009 Endo 13 10

Food accumulation deep pocket & vitaltooth Calculi & root concavity

8/31/2009 Endo 13 11

Generalized poor periodontal conditionGeneralized deep pocketGeneralized Periodontal abscessPrevious perio RxDevelopmental defectsLateral canalFurcation involvementSound non vital toothResolution after perio Rx and RCT

8/31/2009 Endo 13 12

Palato-gingival groove ofmaxillary lateralliincisor

Cervical enamel projectionon mandibular molar

8/31/2009 Endo 13 13

8/31/2009 Endo 13 14

Generalized poor periodontal conditionGeneralized deep pocketGeneralized Periodontal abscessCarious non vital toothTwo lesions coalesceResolution depend on perio Rx and RCTand amount of bone loss

8/31/2009 Endo 13 15

8/31/2009 Endo 13 16

Generalized poor periodontal conditionGeneralized deep pocketGeneralized Periodontal abscessCarious non vital toothResolution depend on perio Rx and RCTand amount of bone loss

8/31/2009 Endo 13 17

8/31/2009 Endo 13 18

8/31/2009 Endo 13 19

Clinical

Origin of infection

Vitality

Restorative

Plaque / calculus

Inflammation

Pockets

PH value

Trauma

Microbial

Treatment

8/31/2009

Pulpal

Pulpal

Nonvital

Deep or extensive

Not related

Acute

Single and narrow

Often acid

Iry or IIry

Few

Root canal therapy

Endo 13

Periodontal

Periodontal

Vital

Not related

Primary cause

Chronic

Wide, coronally and multiple

Usually alkaline

Contributing factor

complex

Periodontal treatment

20

Radiological

Pattern

Bone loss

Periapical

Vertical bone loss

Treatment

8/31/2009

Pulpal

Localized

Wider apically

Radiolucent

No

Root canal therapy

Endo 13

Periodontal

Generalized

Wider coronally

Not often related

Yes

Periodontal treatment

21

Histopathology

Junctional epithelium

Granulation tissue

Gingival

Treatment

8/31/2009

Pulpal

No apical migration

Apical minimum

Normal

Root canal therapy

Endo 13

Periodontal

Apical migration

Coronal larger

Some recession

Periodontal treatment

22

Traditional endodontic & periodontic RxResection (extraction or root amputation)Implant or fixed prosthesisRestoring (bone replacement graft usingguided tissue and bone regenerationtechniques)

8/31/2009 Endo 13 23

Root fractureRoot perforationRoot cariesDehiscenceFenestrationin multy rooted tooth

External root resorptionImpaired root canal treatmentsevere periodontitisFurcation involvement

8/31/2009 Endo 13 24

Deep pocket and calcifiedmesial root

Five years after rootamputation

8/31/2009 Endo 13 25

Fractured toothExtensive decayed toothExternal root resorptionInternal root resorptionLateral perforation

8/31/2009 Endo 13 26

Fractured toothExtensive decayed toothExternal root resorptionInternal root resorptionLateral perforation

8/31/2009 Endo 13 27

Less than 1cmReduced enamel epitheliumRemnant of dental laminaCell rest of MalassezFifth to seventh decayed of lifeMale predominantMandibular posterior regionUnicystic or multicystic

8/31/2009 Endo 13 28

Discharging sinus After flap reflection

8/31/2009 Endo 13 29

After enucleation After three month

8/31/2009 Endo 13 30

Before two years After forming lesion

8/31/2009 Endo 13 31

After one year post operativelyRadiologic ally clinically

8/31/2009 Endo 13 32

Reflected buccul flap Osseous window

8/31/2009 Endo 13 33

Repaired defect with freeze dried bone allograft and coveredwith a collagen membrane

Before surgery

8/31/2009 Endo 13 34

At the time of surgery After 6 month

8/31/2009 Endo 13 35

After two years Before surgery

8/31/2009 Endo 13 36

PretreatmentReflected full thickness muco-periosteal flap 7 mm pocket

8/31/2009 Endo 13 37

Oseouss defect filled withcancellous bovine bone (BioOss)

Collagen membranes(Ossix) over the BioOss

8/31/2009 Endo 13 38

Preoperative One year after treatment

8/31/2009 Endo 13 39

Preoperative One year after treatment

8/31/2009 Endo 13 40