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Case Reports
. 2020 Oct 26;8(20):5049-5056.
doi: 10.12998/wjcc.v8.i20.5049.

Successful management of a tooth with endodontic-periodontal lesion: A case report

Hamed Alshawwa  1 , Jia-Feng Wang  1 , Min Liu  2 , Shu-Fen Sun  3
Affiliations
Case Reports

Successful management of a tooth with endodontic-periodontal lesion: A case report

Hamed Alshawwa et al. World J Clin Cases. .

Abstract

Background: Endodontic-periodontal lesion is a commonly encountered dental condition. However, the prognosis of the condition varies from good to poor. Some cases are associated with a poor prognosis that requires tooth extraction. This report presents a case of an endodontic-periodontal lesion in a tooth that was successfully treated by root canal treatment.

Case summary: A 51-year-old female patient with no medical history complained about persistent pain and discomfort in her left mandibular first molar. Clinical examination showed the left mandibular first molar with poor restoration. It was also associated with underlying necrotic pulp and periodontal involvement. Radiographic examination revealed visible bone defects in the apical and periodontal areas. Based on the findings, the patient was diagnosed with a primary endodontic lesion. A root canal treatment for the endodontic lesion was performed. The patient received a coronal all-ceramic endocrown restoration. A follow-up was arranged to check the prognosis. At the 3 mo follow-up, the clinical and radiography evaluations showed complete disappearance of signs and symptoms and an increase in the radiopacity of the root area.

Conclusion: Despite the poor prognosis associated with many endodontic lesions, this case report highlights that a good prognosis is still possible for an endodontic lesion with apical and periodontal bone loss. In this case, it was achieved via successful root canal treatment without the need for periodontal or surgical intervention.

Keywords: Apical bone defect; Case report; Conservative; Endo-perio lesion; Nonsurgical root canal treatment; Primary endodontic lesion; Root canal treatment.

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Conflict of interest statement

Conflict-of-interest statement: The authors declare that they have no conflict of interest.

Figures

Figure 1
Figure 1
Periapical radiograph. A: Initial preoperative periapical radiograph; B: Gutta-Percha cone fitting and working length confirmation with periapical radiograph; C: Post-obturation periapical radiograph; D: Periapical radiograph at the 3 mo follow-up.
Figure 2
Figure 2
Images of cone beam computed tomography showing buccal, bifurcation, and apical bone resorption (A-F).
Figure 3
Figure 3
Flow chart timeline of the treatment plan.
See this image and copyright information in PMC

References

    1. Gutmann JL. Prevalence, location, and patency of accessory canals in the furcation region of permanent molars. J Periodontol. 1978;49:21–26. - PubMed
    1. Simring M, Goldberg M. The pulpal pocket approach: retrograde periodontitis. J Periodontol. 1964;35:22–48.
    1. Das AC, Sahoo SK, Parihar AS, Bhardwaj SS, Babaji P, Varghese JG. Evaluation of role of periodontal pathogens in endodontic periodontal diseases. J Family Med Prim Care. 2020;9:239–242. - PMC - PubMed
    1. Adriaens PA, De Boever JA, Loesche WJ. Bacterial invasion in root cementum and radicular dentin of periodontally diseased teeth in humans. A reservoir of periodontopathic bacteria. J Periodontol. 1988;59:222–230. - PubMed
    1. Adriaens PA, Edwards CA, De Boever JA, Loesche WJ. Ultrastructural observations on bacterial invasion in cementum and radicular dentin of periodontally diseased human teeth. J Periodontol. 1988;59:493–503. - PubMed

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