The healing potential of periodontal-endodontic lesions

Osseous lesions involving the periodontium, and which are sometimes associated with discomfort and pathologic changes such as swelling or the development of a sinus tract, are not always due to periodontal disease. Thus, it is not uncommon to find a dentition with generally good periodontal health but with one tooth having a severe isolated bony periodontal defect. In other cases, periodontal treatment may result in a general improvement, except in relation to one tooth which does not respond to the therapy. Very often these cases are instances of combined periodontal-endodontic lesions, but which are solely of pulpal origin. This paper serves to help the dental practitioner recognise the disease process underlying the condition and appreciate its effective management with non-surgical root canal treatment.