Elle and Elina

Periodontitis Associated with Endodontic Lesions
Lesions that affect the periodontium and pulp are classified by the sequence in the disease process.

Endo-perio lesion:
With these lesions the pulp of the tooth becomes necrotic before any periodontal changes occur. The lesion originates in the pulp.
- What it would look like clinically: localized deep periodontal pocket and fucation involvement may be present due to loss of attachment and bone.
- What it would look like radiographically: periapical abscess that appears as a circular radiolucent lesion on the apex of the root, loss of the lamina dura, destruction of the PDL, and localized bone loss.
- How you would diagnosis it: radiographically
Differential diagnosis: periapical cyst, lateral perio cyst, or periapical granuloma.



Perio-endo lesion:
These types of lesions result from bacterial infection from a peio. pocket that can spread through the accessory canals to the pulp which will result in pulp necrosis.
- What it would look like clinically: loss of attachment, root exposure, erythematous, inflammation when probing a deep pocket measurement will be noted.
- What it would look like radiographically: fuzzy lamina dura, break in the PDL, radiolucencies around the roots, and intra-radicular radiolucencies may be present.
- How you would diagnosis it: radiographically
Differential diagnosis: periapical cyst or lateral perio cyst.

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Combined lesion:
These result from development and extension of an endodontic lesion into an existing periodontal lesion.
- What it would look like clinically: These lesions have combined characteristics of both of the above lesions.
- What it would look like radiographically: advanced bone loss with intrabony defect, and possible intra-radicular radiolucencies.
- How you would diagnosis it: Clinically, radiographically, and a thorough history to assess the cause of each lesion.
Differential diagnosis: periapical cyst or lateral perio cyst.