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Periodontitis in combination with endodontic lesions
Endodontic-periodontic lesions are distinguished from periodontic-endodontic and combined lesions.
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- The periodontal lesion is preceded by pulp necrosis
- An originally apical lesion penetrates into the oral cavity through the periodontium and causes destruction of the bone and surrounding tissue
- Bacteria from an infected pulp can gain access to the surroundings through subsidiary pulp channels and may, for example, cause furcation involvement.
- Existing periodontitis can lead through pockets with bone loss to the pulp becoming infected and necrotic
- The infection can take place through secondary channels or through the apical foramen with advancing bone loss
- Another cause for this lesion can be that cementum is lost due to scaling and dentin channels are exposed which can bring the infection into the tooth.
(Blieden 1999; Carranza et al. 2006)
- Combined lesions occur at teeth where apical periodontitis and marginal periodontitis have developed independently of one other.
- Blieden, T. M. (1999): Tooth-related issues. In: Ann. Periodontol. 4 (1), S. 91–97. DOI: 10.1902/annals.1922.214.171.124
- Carranza, Fermin A.; Newman, Michael G.; Takei, Henry H.; Klokkevold, Perry R. (2006): Carranza's clinical periodontology. 10th ed. St. Louis, Mo.: Saunders Elsevier