A dilemma: Diagnosis and treatment planning of combined endo-period lesions

Abstract

Combined endodontic periodontal lesions are localized, circumscribed areas of bacterial infection originated from either dental pulp or periodontal tissues surrounding the involved teeth. Cross seeding of bacteria can occur in either direction through communication pathways such as apical foramen, lateral canals etc. This lesion provides many diagnostic challenges to clinicians, particularly when they occur concurrently. Once both the pulp and the periodontal tissues have become involved, the diagnosis and management of the situation may become more complex and require extra considerations. The purpose of paper was to highlight the common difficulties encountered in making the diagnosis of such lesions and suggest sequences step by step to achieve the goals of correct diagnosis and treatment planning.