11/7/2023 0 Comments Define parl dental endo![]() Radiographically, bony destruction is limited to the periapical area or the termini of the lateral canals. Swelling or sinus tracts, if present, are typically located in close proximity to the periapex. Periodontal attachment loss is not detectable. Clinically, the pulp tissue is often completely necrotic. Primary endo lesions originate from the dental pulp. Simon classified perio-endo lesions based on both clinical and radiographic findings 2: 5 Despite the many changes proposed since 1972, Simon's original classification system remains the most universally accepted therefore, the remainder of this article will utilize his original terminology. 4 In 2009, Abbott and Salgado proposed a simplified classification system that described perio-endo lesions as "concurrent" lesions, either with or without communication between the endodontic and periodontal pathoses. Decades later, Torabinejad and Trope proposed yet another classification system, which was based on the origin of the periodontal pocket and used six categories: lesions of endodontic origin, lesions of periodontal origin, combined endo-perio lesions, separate endodontic and periodontal lesions, lesions with communication, and lesions without communication. ![]() Primary perio/secondary endo lesions were further divided by pulp vitality, and combined lesions were left as a distinct category. ![]() 3 He further divided primary endo/secondary perio lesions into those caused by acute or chronic periradicular pathoses or iatrogenic lesions following endodontic treatment, such as perforations. In 1975, Guldener expanded upon Simon's classification system with regard to both the cause and the treatment of the lesion. 2 Diagnostic categories included primary endo, primary perio, primary endo/secondary perio, primary perio/secondary endo, and true combined lesions (Figure 1). The initial classification system that was developed by Simon in 1972 is based on the presumed origin of the lesion, namely either the dental pulp or the periodontium. To help clinicians better understand this unique and challenging pathologic entity, this article will review the history of perio-endo terminology, diagnostic criteria, differential diagnoses, and multidisciplinary treatment strategies.ĭefinitions of perio-endo lesions exhibit significant variability in the literature. ![]() These variations, as well as the clinical and radiographic similarities between perio-endo lesions and other dentoalveolar pathoses, complicate their diagnosis. 1 Published literature on the subject exhibits variations in terminology, diagnostic criteria, and management strategies. These pathways provide an egress for pulpal disease to affect the periodontium and conversely, an ingress for periodontal disease to affect the pulp. Both of these tissues are mesenchymal in origin and once mature, remain connected via apical foramina, lateral canals, exposed dentinal tubules, and developmental grooves. The anatomic connections between the dental pulp and the periodontium provide a pathway for perio-endo communication. Yi-Chu Wu, DDS | Brooke Blicher, DMD | Rebekah Lucier Pryles, DMD | Jarshen Lin, DDSĭespite decades of literature describing periodontal-endodontic (perio-endo) lesions, they remain an often misunderstood disease entity. Understanding Periodontal-Endodontic InfectionsĬonsistent terminology facilitates improved diagnosis and treatment
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