Aim: To illustrate, with two clinical cases of endoperiodontal lesions, the clinical application of the new classification of periodontal and peri-implant diseases and conditions. Background: The endodont and the periodont are two entities that communicate with each other through physiological communication channels (apical foramen, lateral and secondary canals, and dentinal tubules) resulting in close anatomical and functional interaction. An endoperiodontal lesion is defined by pathological communication between the endodontic and periodontal tissues in a given tooth, according to the definition given by the new classification of periodontal and peri-implant diseases and conditions from the work of the Chicago Consensus Conference in 2017. This new classification differentiates the lesions with and without root damage. Diagnosis and therapeutic strategy will be analyzed through two clinical cases. Review results: The clinical cases we presented show that the treatment of these lesions must involve endodontic and periodontal management due to the intimate relationship between the tooth and periodontium. Conclusion: The classification of periodontal and peri-implant diseases and conditions provides a clinical focus on endoperiodontal lesions, based on signs and symptoms that have a direct effect on the prognosis and the treatment of the tooth. The pathological communication between the endodont and the periodontium complicates the management of the involved tooth. Clinical significance: Chicago\'s new classification of periodontal and peri-implant diseases and conditions offers an up-to-date vision of periodontal lesions management and highlights the intimate links between endodontic and periodontal tissues.
Papapanou PN, Sanz M, Buduneli N, et al. Periodontitis: consensus report of workgroup 2 of the 2017 world workshop on the classification of periodontal and peri-implant diseases and conditions: classification and case definitions for periodontitis. J Periodontol 2018;89(Suppl 1):S173–S182.
Herrera D, Retamal-Valdes B, Alonso B, et al. Acute periodontal lesions (periodontal abscesses and necrotizing periodontal diseases) and endo-periodontal lesions. J Clin Periodontol 2018;45(Suppl 20):S78–S94.
Caton JG, Armitage G, Berglundh T, et al. A new classification scheme for periodontal and peri-implant diseases and conditions—introduction and key changes from the 1999 classification. J Clin Periodontol 2018;45(Suppl 20):S1–S8.
Armitage GC. Development of a classification system for periodontal diseases and conditions. Ann Periodontol 1999;4(1):1–6. DOI: 10.1902/annals.19220.127.116.11.
Tsesis I, Nemcovsky CE, Nissan J, et al. Endodontic-Periodontal Lesions: Evidence-Based Multidisciplinary Clinical Management. Springer; 2019.
Tsesis I, Rosenberg E, Faivishevsky V, et al. Prevalence and associated periodontal status of teeth with root perforation: a retrospective study of 2,002 patients’ medical records. J Endod 2010;36(5):797–800. DOI: 10.1016/j.joen.2010.02.012.
Mente J, Hage N, Pfefferle T, et al. Treatment outcome of mineral trioxide aggregate: repair of root perforations. J Endod 2010;36(2):208–213. DOI: 10.1016/j.joen.2009.10.012.
Mente J, Leo M, Panagidis D, et al. Treatment outcome of mineral trioxide aggregate: repair of root perforations—long-term results. J Endod 2014;40(6):790–796. DOI: 10.1016/j.joen.2014.02.003.
Siew K, Lee AHC, Cheung GSP. Treatment outcome of repaired root perforation: a systematic review and meta-analysis. J Endod 2015;41(11):1795–1804. DOI: 10.1016/j.joen.2015.07.007.
Abulhamael AM, Tandon R, Alzamzami ZT, et al. Treatment decision-making of cracked teeth: survey of american endodontists. J Contemp Dent Pr 20(5):543–547.
Al Shayeb KNA, Turner W, Gillam DG. Periodontal probing: a review. Prim Dent J 2014;3(3):25–29. DOI: 10.1308/205016814812736619.
Listgarten MA. Periodontal probing: what does it mean? J Clin Periodontol 1980;7(3):165–176. DOI: 10.1111/j.1600-051X.1980.tb01960.x.
Abbott P, Salgado JC. Strategies for the endodontic management of concurrent endodontic and periodontal diseases. Aust Dent J 2009;54(Suppl 1):S70–S85.
Gupta S, Tewari S, Tewari S, et al. Effect of time lapse between endodontic and periodontal therapies on the healing of concurrent endodontic-periodontal lesions without communication: a prospective randomized clinical trial. J Endod 2015;41(6):785–790. DOI: 10.1016/j.joen.2015.02.015.
Tewari S, Sharma G, Tewari S, et al. Effect of immediate periodontal surgical treatment on periodontal healing in combined endodontic–periodontal lesions with communication—a randomized clinical trial. J Oral Biol Craniofacial Res 2018;8(2):105–112. DOI: 10.1016/j.jobcr.2018.04.002.
Song M, Kang M, Kang DR, et al. Comparison of the effect of endodontic-periodontal combined lesion on the outcome of endodontic microsurgery with that of isolated endodontic lesion: survival analysis using propensity score analysis. Clin Oral Investig 2018;22(4):1717–1724. DOI: 10.1007/s00784-017-2265-1.
Chapple ILC, Mealey BL, Van Dyke TE, et al. Periodontal health and gingival diseases and conditions on an intact and a reduced periodontium: consensus report of workgroup 1 of the 2017 world workshop on the classification of periodontal and peri-implant diseases and conditions. J Periodontol 2018;89(Suppl 1):S74–S84.
Hamp S-E, Nyman S, Lindhe J. Periodontal treatment of multi rooted teeth. J Clin Periodontol 1975;2(3):126–135. DOI: 10.1111/j.1600-051X.1975.tb01734.x.
Ørstavik D, Kerekes K, Eriksen HM. The periapical index: a scoring system for radiographic assessment of apical periodontitis. Dent Traumatol 1986;2(1):20–34. DOI: 10.1111/j.1600-9657.1986.tb00119.x.