29. SOLUTION OF COMBINED PERIO-ENDO PROBLEM

Tsv. Boyarova¹, P. Kolarova²

Medical University Sofia, Bulgaria

Faculty of Dental Medicine, Department of Periodontology

¹Assistant Professor, Department of Periodontology, Sofia

²Postgraduate student, Department of Periodontology, Sofia

The true combined perio-endo lesions are result from confluence of endodontic and periodontal lesions that at first developed independently. The clinical examination revels deep pocket and radiographic examination exhibits large periapical lesion on the tooth, communicating with deep angular defect up to the apical area. The prognosis of such teeth is questionable and they are extracted like hopeless. In the case as presented here extraction of questioned tooth would necessitate extensive and esthetically difficult reconstructionand in this case is recommended endodontic and periodontal treatment. The combined periodontal and endodontic therapy is difficult and clinical efforts must to be viewed as “heroic”.

Aim: To present clinical case with perio-endo lesion and solution by endodontic treatment and regenerative therapy.

Clinical case: A 28-year-old female presented untreated severe periodontitis and apical periodontitis on tooth 34. The clinical examination revels deep distofatial pocket with suppuration and gingival shrinkage and radiographically large periapical lesion communicating with angular bone defect. After initial phase of periodontal and endodontic treatment the patient undergoes regenerative therapy with Bio-Gide® and Bio-Oss Collagen®. Temporary bridge is made during healing process.

Results: One wear later there are clinical and radiographic sighs of healing: reduction of pocket depth and restoration of the morphology of interdental papilla and radiographically bone filling and reduction of radiolucency in the apical area.

Keywords: periodontitis, regenerative therapy, combined perio-endo lesions

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