Treatment of Tooth with Combined Endodontic-Periodontal Lesion: a Case Report - การรักษาฟันทีมีรอยโรคร่วมระหว่าง โรคเนื้อเยื่อในและโรคปริทันต์: รายงานผู้ป่วย

Abstract

            Endodontic, periodontal and combined endodontic-periodontal lesions may share common clinical manifestations that interrelate to each other. Correct diagnosis of the primary cause of lesion is crucial for successful treatment. A 26-year-old woman presented with gingival swelling on right lower molar. Clinical examination revealed gingival swelling in buccal area of tooth 46 with large amalgam restoration and presence of a periodontal pocket at midbuccal of the tooth. An intraoral periapical radiograph of tooth 46 revealed periapical radiolucent lesion which extended to furcation area. Furcation bone loss was noted.These initial manifestations were compatible with periodontal disease. However, electric pulp test of this
tooth was negative. Vigilant examination showed only solitary deep and narrow pocket and the radiograph showed that the level of alveolar crest in both mesial and distal sides of tooth 46 was normal. These additional findings confirmed that the lesion was endodontic origin. Primary endodontic lesion was diagnosed and the woman underwent merely conventional root canal treatment. Periodic recalls were performed at 6,12 and 18 months after the completion of root canal treatment. Tooth 46 was found to be asymptomatic. The gingival condition was good and the periodontal pocket was normal. The healing of periapical and furcation lesions was also presented. Radiographic examination showed regeneration of bone in the areas.
Key words: endodontic-periodontal lesion, periodontal pocket, root canal treatment