Endoperiodontal lesions

Abstract

Endodontics and periodontics are the specialties of dentistry that deal with diagnosis, treatment, and prognosis
of pulp and periodontal diseases, respectively. The set of both specialties give endoperiodontology, which studies
injuries caused by diseases of the pulp and periodontum. The relation between the last two mentioned is very
close due to its embryonic, anatomic, and functional interrelation. There is a variety of pulpal-periodontal
communications, such as, dentinal tubules, lateral and accesory canals, apical foramen, palatogingival groove,
root perforations, and vertical root fractures.
The endo-periodontal lesions are characterized bye associating pulpal and periodontal pathologies in the
same dental element. There lesions can be difficult to diagnose and prognosticate depending on contributing
factors, such as, poor root canal treatment, coronal leakages, trauma, root resorption; etiologic factors like living
pathongens (bacteria, virus, fungi), non-living pathogens (amalgams, root fillings, paper points), and intrinsec
or extrinsec pathogens (cholesterol, Rushton hyaline bodies), and others. Namely, the flow of infection can start
by a necrotic pulp which afterwards can affect the periodontum or viceversa. The treatment also varies in each
diagnosed lesion, but they all require at least one of both endodontic or periodontal treatments.