Therapeutic Strategies for Complex Endoperiodontal Lesions

Abstract

Introduction: endodontics and periodontics, key specialties in dentistry, are concerned with diagnosing and treating pulpal and periodontal diseases, respectively. Both structures share a common embryological origin and several communication pathways, such as the apical foramen and dentinal tubules, which facilitate the spread of infections between them. Endoperiodontal lesions arise when a pathological process simultaneously affects the dental pulp and periodontium, complicating diagnosis and treatment due to the anatomical and functional interconnection. Development: the diagnosis of endoperiodontal lesions was based on a detailed clinical history, thorough clinical examinations and advanced imaging studies such as radiographs and CT scans. The periapical index (PAI) was used to assess the bone health around the dental root and classify the lesions. Treatments depended on the nature of the lesion: primary endodontic lesions responded well to root canal treatment, while primary periodontal lesions required both surgical and non-surgical procedures. In combined cases, therapeutic success depended on an interdisciplinary approach that integrated both treatments. Iatrogenic complications and factors such as patient adherence significantly influenced outcomes. Conclusions: it was concluded that the management of endoperiodontal lesions requires a comprehensive understanding of the relationships between the pulp and periodontium, along with the use of advanced diagnostic tools. Personalized treatments, based on lesion etiology, are essential to optimize outcomes and preserve oral health.