Aim: Endodontic-periodontal disease is difficult to treat. The difficulty is related to establishing which component of the inflammation is of endodontic origin and which is periodontal. It is therefore crucial to reveal the origin of endodontic-periodontal disease before initialising root canal treatment. It is important to realise that if the root canal treatment will lead to a severe periodontal condition, the necessary efforts to save the tooth will be ccomplex and expensive and the outcome will be uncertain. This article describes the cases of two patients diagnosed with endodontic-periodontal lesions.
Keywords: endodontic-periodontal disease, endodontic-periodontal lesions, periodontal abscess, root canal treatment
Materials and methods: Two teeth with different types of endodontic-periodontal lesions were treated and followed up. The first was a type II endodontic-periodontal lesion (according to Messing and Stock’s classification) and the second was a type IV lesion. In case 1, root canal treatment was carried out over two visits with calcium hydroxide as an intracanal dressing, and in case 2, the appropriate treatment was provided for a type IV lesion.
Results: In case 1, complete healing was observed after root canal treatment. In case 2, progressive bone reconstruction was visible around the treated tooth after 1 year of observation. The following year, a decision was made to extract the tooth due to the patient’s lack of cooperation with the dental practitioner.
Conclusion: It is important to properly diagnose and reveal the origin of endodontic-periodontal disease before initialising root canal treatment, but the patient’s cooperation with the dental practitioner is also crucial, and can contribute to successful treatment outcomes.