Keywords
Terapia de modalidad combinada; Endodoncia; Enfermedad periodontal.
How to Cite
Abstract
The aim of this case study is to report a successful clinical case of an endo-perio lesion in a tooth with an initially unfavorable prognosis, followed up for 18 months. A male patient, public servant, non-smoker, without a history of diabetes, and married sought dental treatment in 1995 due to periodontal problems. He was then 40 years old and diagnosed with moderate to advanced periodontal disease. The initial treatment consisted of supra and subgingival scaling, followed by the extraction of teeth indicated for removal. After discharge, the patient adhered to a preventive periodic maintenance (PPM) program to control periodontal disease recurrence. In 2021, tooth 43 showed an unfavorable endo-perio lesion during a routine check-up. Despite treatment options, the patient opted for conservative treatment with endodontic and periodontal procedures. Simultaneously, PPM sessions were performed. The patient was monitored every six months, showing regression of periodontal pockets and significant improvement after 18 months. This case highlights the importance of patient adherence to PPM, demonstrating that a conservative approach and proper maintenance can lead to positive clinical outcomes even in cases with an initially unfavorable prognosis.
References
Rotstein I., Simon J. The endo-perio lesion: a critical appraisal of the disease condition. Endod Topics. 2006; 13 (1): 34-56.
Singh P. Endo-perio dilemma: a brief review. Dent Res J. 2011; 8 (1): 39-47.
Guo J., Li Y., Lin X., Yang X., Shi W., Lu X. Prognostic Factors of Combined Periodontal and Endodontic Lesions: A Retrospective Study. Contrast Media Mol Imaging. 2022; 2022: e5042097.
Kim E., Song J.S., Jung I.Y., Lee S.J., Kim, S. Prospective clinical study evaluating endodontic microsurgery outcomes for cases with lesions of endodontic origin compared with cases with lesions of combined periodontal-endodontic origin. J Endod. 2008; 34 (5): 546-551.
Herrera D., Retamal-Valdes B., Alonso B., Feres M. Acute periodontal lesions (periodontal abscesses and necrotizing periodontal diseases) and endo-periodontal lesions. J Clin Periodontol. 2018; 45: S78-S94.
Takahashi K., Yamazaki K., Yamazaki M., Kato Y., Baba Y. Personalized Medicine Based on the Pathogenesis and Risk Assessment of Endodontic-Periodontal Lesions. J Pers Med. 2022; 12 (10): 1688.
Nagendrababu V., Chong B.S., McCabe P., Shah P.K., Priya E., Jayaraman J., Pulikkotil S.J., Setzer F.C., Sunde P.T., Dummer P.M.H. PRICE 2020 Guidelines for reporting case reports in Endodontics: A consensus-based development. Int Endod J. 2020; 53 (5): 619-626.
Manresa C., Sanz-Mirelles E.C., Twigg J., Bravo M. Supportive periodontal therapy (SPT) for maintaining the dentition in adults treated for periodontitis. Cochrane Database Syst Rev. 2018; 1 (1): CD009376.
Al-Fouzan K. A New Classification of Endodontic-Periodontal Lesions. Int J Dent. 2014; 2014: 919173.
Grudianov A.I., Makeeva M.K., Pyatigorskaya N.V. Modern concepts of etiology, pathogenesis and treatment approaches to endo-perio lesions. Annals Russ Acad Med Scien. 2013; 68 (8): 34-36.
Aksel H., Serper A. A case series associated with different kinds of endo-perio lesions. J Clin Exp Dent. 2014; 6 (1): 91.
Jakovljevic A., Miletic M., Nikolic N., Beljic-Ivanovic K., Andric M., Milasin J. Notch signaling pathway mediates alveolar bone resorption in apical periodontitis. Med Hypotheses. 2019; 124: 87-90.
Harrington G.W., Steiner D.R., Ammons W.F. The periodontal-endodontic controversy. Periodontol 2000. 2002; 30 (1): 123-130.
Friedman S. The prognosis and expected outcome of apical surgery. Endod Topics. 2005; 11 (1): 219-262.
Fang F., Gao B., He T., Lin Y. Efficacy of root canal therapy combined with basic periodontal therapy and its impact on inflammatory responses in patients with combined periodontal-endodontic lesions. Am J Transl Res. 2021; 13 (12): 14149-14156.