This document discusses various perio-endo lesions and their treatment. It covers topics like non-vital teeth with furcation involvement and lateral canals resolving after root canal treatment. It also discusses generalized poor periodontal conditions with deep pockets and abscesses resolving with treatment. The document contrasts clinical, radiological, and histological features of pulpal versus periodontal lesions and their different treatments. It presents various advanced treatment options for complex perio-endo cases like resection, implants, bone grafts, and guided tissue regeneration.

1. Perio Endo Lesions
8/31/2009 Endo 13 1

2. Medical history
Senbility testing
Pocket depth
Furcation involvement
Tooth mobility
Radiograph
8/31/2009 Endo 13 2

3. Non vital carious tooth
Lateral canal
Furcation involvement
Local Periodontal abscess
Localized deep pocket
Good periodontal condition
Resolution after RCT
8/31/2009 Endo 13 3

4. Drain through the periodontiam Buccul abscess
8/31/2009 Endo 13 4

5. Drain through the furcation
8/31/2009 Endo 13 5

6. Non vital tooth
Lateral canal
Furcation involvement
Local Periodontal abscess
Localized deep pocket
poor periodontal condition
Resolution after RCT + perio Rx
8/31/2009 Endo 13 6

7. Deep periodontal pocket Periodontal probe 6mm
8/31/2009 Endo 13 7

8. Nonvital second premolar Lateral canal
8/31/2009 Endo 13 8

9. 8/31/2009 Endo 13 9

10. Generalized poor periodontal condition
Generalized deep pocket
Generalized Periodontal abscess
Developmental defects
Lateral canal
Furcation involvement
Sound vital or nonvital tooth
Resolution after perio Rx + RCT
8/31/2009 Endo 13 10

11. Food accumulation deep pocket & vital
tooth Calculi & root concavity
8/31/2009 Endo 13 11

12. Generalized poor periodontal condition
Generalized deep pocket
Generalized Periodontal abscess
Previous perio Rx
Developmental defects
Lateral canal
Furcation involvement
Sound non vital tooth
Resolution after perio Rx and RCT
8/31/2009 Endo 13 12

13. Palato-gingival groove of Cervical enamel projection
maxillary lateralliincisor on mandibular molar
8/31/2009 Endo 13 13

14. 8/31/2009 Endo 13 14

15. Generalized poor periodontal condition
Generalized deep pocket
Generalized Periodontal abscess
Carious non vital tooth
Two lesions coalesce
Resolution depend on perio Rx and RCT
and amount of bone loss
8/31/2009 Endo 13 15

16. 8/31/2009 Endo 13 16

17. Generalized poor periodontal condition
Generalized deep pocket
Generalized Periodontal abscess
Carious non vital tooth
Resolution depend on perio Rx and RCT
and amount of bone loss
8/31/2009 Endo 13 17

18. 8/31/2009 Endo 13 18

19. 8/31/2009 Endo 13 19

20. Clinical Pulpal Periodontal
Origin of infection Pulpal Periodontal
Vitality Nonvital Vital
Restorative Deep or extensive Not related
Plaque / calculus Not related Primary cause
Inflammation Acute Chronic
Pockets Single and narrow Wide, coronally and multiple
PH value Often acid Usually alkaline
Trauma Iry or IIry Contributing factor
Microbial Few complex
Treatment Root canal therapy Periodontal treatment
8/31/2009 Endo 13 20

21. Radiological Pulpal Periodontal
Pattern Localized Generalized
Bone loss Wider apically Wider coronally
Periapical Radiolucent Not often related
Vertical bone loss No Yes
Treatment Root canal therapy Periodontal treatment
8/31/2009 Endo 13 21

22. Histopathology Pulpal Periodontal
Junctional epithelium No apical migration Apical migration
Granulation tissue Apical minimum Coronal larger
Gingival Normal Some recession
Treatment Root canal therapy Periodontal treatment
8/31/2009 Endo 13 22

23. Traditional endodontic & periodontic Rx
Resection (extraction or root amputation)
Implant or fixed prosthesis
Restoring (bone replacement graft using
guided tissue and bone regeneration
techniques)
8/31/2009 Endo 13 23

24. Root fracture
Root perforation
Root caries
Dehiscence
Fenestration
in multy rooted tooth
External root resorption
Impaired root canal treatment
severe periodontitis
Furcation involvement
8/31/2009 Endo 13 24

25. Deep pocket and calcified Five years after root
mesial root amputation
8/31/2009 Endo 13 25

26. Fractured tooth
Extensive decayed tooth
External root resorption
Internal root resorption
Lateral perforation
8/31/2009 Endo 13 26

27. Fractured tooth
Extensive decayed tooth
External root resorption
Internal root resorption
Lateral perforation
8/31/2009 Endo 13 27

28. Less than 1cm
Reduced enamel epithelium
Remnant of dental lamina
Cell rest of Malassez
Fifth to seventh decayed of life
Male predominant
Mandibular posterior region
Unicystic or multicystic
8/31/2009 Endo 13 28

29. Discharging sinus After flap reflection
8/31/2009 Endo 13 29

30. After enucleation After three month
8/31/2009 Endo 13 30

31. Before two years After forming lesion
8/31/2009 Endo 13 31

32. After one year post operatively
Radiologic ally clinically
8/31/2009 Endo 13 32

33. Reflected buccul flap Osseous window
8/31/2009 Endo 13 33

34. Repaired defect with freeze dried bone allograft and covered
with a collagen membrane
Before surgery
8/31/2009 Endo 13 34

35. At the time of surgery After 6 month
8/31/2009 Endo 13 35

36. After two years Before surgery
8/31/2009 Endo 13 36

37. Reflected full thickness muco-
Pretreatment periosteal flap 7 mm pocket
8/31/2009 Endo 13 37

38. Oseouss defect filled with Collagen membranes
cancellous bovine bone (BioOss) (Ossix) over the BioOss
8/31/2009 Endo 13 38

39. Preoperative One year after treatment
8/31/2009 Endo 13 39

40. Preoperative One year after treatment
8/31/2009 Endo 13 40