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Manejo multidisciplinario de una lesión endo-periódica complicada por un desgarro de cemento: un informe de caso
Nishanth D Sadhak1, Akshaya Pallod2, Shreyas Oza3
1University of the Pacific Arthur A. Dugoni School of Dentistry, San Francisco, CA, USA.
Restorative dentistry & endodontics
|September 4, 2025
Resumen
Este informe de caso detalla el tratamiento exitoso de las lesiones endodóntico-periodontales (EPL) complicadas por desgarros cementales. Un enfoque endodóntico y quirúrgico combinado condujo a una curación y regeneración ósea significativas en un caso desafiante de EPL.
Área de la Ciencia:
- La odontología
- La endodoncia
- Periodontología
Sus antecedentes:
- Las lesiones endodontico-periodontales (EPL) plantean desafíos diagnósticos y terapéuticos, especialmente cuando se complican por desgarros cementales.
- Las lágrimas de cemento pueden imitar o exacerbar la EPL, complicando la planificación del tratamiento y el pronóstico.
- El diagnóstico preciso es crucial para el manejo eficaz de las EPL complejas.
Objetivo del estudio:
- Para describir el manejo exitoso de un molar mandibular con una lesión endodóntico-periodontal complicada por un desgarro cemental.
- Para resaltar la importancia de considerar las lágrimas de cemento en el diagnóstico diferencial de la EPL.
- Demostrar la eficacia de un enfoque endodóntico y periodontal multidisciplinario.
Principales métodos:
- Un informe de caso de un paciente varón de 66 años con un segundo molar mandibular (# 18) que se presenta con un EPL y un desgarro cemental.
- El examen clínico y radiográfico reveló un tracto sinusal de drenaje, bolsas periodontales profundas, una lesión en forma de "J" y un fragmento de cemento radiopaca.
- El tratamiento consistió en un nuevo tratamiento endodóntico combinado con la extirpación quirúrgica del desgarro de cemento.
Principales resultados:
- Resolución exitosa del tracto sinusal de drenaje y las bolsas periodontales.
- Mejora significativa de la salud periodontal y regeneración ósea observada en el seguimiento de 24 meses.
- Evidencia radiográfica de la resolución de la lesión y la integración exitosa del área tratada.
Conclusiones:
- Las lágrimas de cemento deben considerarse en el diagnóstico diferencial de lesiones endodóntico-periodontales complejas.
- Un enfoque endodóntico y quirúrgico combinado puede lograr resultados predecibles y exitosos para EPLs complicados por desgarros de cemento.
- La gestión multidisciplinaria es clave para el tratamiento de enfermedades endodónticas y periodontales difíciles.
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