The Journal of Contemporary Dental Practice

Register      Login

SEARCH WITHIN CONTENT

FIND ARTICLE

Volume / Issue

Online First

Archive
Related articles

VOLUME 9 , ISSUE 4 ( May, 2008 ) > List of Articles

RESEARCH ARTICLE

Endodontic-periodontic Bifurcation Lesions: A Novel Treatment Option

Shaul Lin, Gabriel Tillinger, Offer Zuckerman

Citation Information : Lin S, Tillinger G, Zuckerman O. Endodontic-periodontic Bifurcation Lesions: A Novel Treatment Option. J Contemp Dent Pract 2008; 9 (4):107-114.

DOI: 10.5005/jcdp-9-4-107

License: CC BY-NC 3.0

Published Online: 01-01-2010

Copyright Statement:  Copyright © 2008; The Author(s).


Abstract

Aim

The purpose of this preliminary clinical report is to suggest a novel treatment modality for periodontal bifurcation lesions of endodontic origin.

Methods and Materials

The study consisted of 11 consecutive patients who presented with periodontal bifurcation lesions of endodontic origin (endo-perio lesions). All patients were followed-up for at least 12 months. Treatment included calcium hydroxide with iodine-potassium iodide placed in the root canals for 90 days followed by canal sealing with gutta-percha and cement during a second stage. Dentin bonding was used to seal the furcation floor to prevent the ingress of bacteria and their by-products to the furcation root area through the accessory canals.

Results

A radiographic examination showed complete healing of the periradicular lesion in all patients. Probing periodontal pocket depths decreased to 2 to 4 mm (mean 3.5 mm), and resolution of the furcation involvement was observed in post-operative clinical evaluations.

Conclusions

The suggested treatment of endo-perio lesions may result in complete healing. Further studies are warranted.

Clinical Significance

This treatment method improves both the disinfection of the bifurcation area and the healing process in endodontically treated teeth considered to be hopeless.

Citation

Lin S, Tillinger G, Zuckerman O. Endodontic-periodontic Bifurcation Lesions: A Novel Treatment Option. J Contemp Dent Pract 2008 May; (9)4:107-114.


PDF Share
  1. Oral histology and embryology. 5th ed. St. Louis: Mosby; 1962.
  2. Clinical diagnosis and treatment of endodontic and periodontal lesions. Quintessence Int. 1993; 24:135-9.
  3. Periodontic-endodontic lesions. Ann Periodontol. 1999; 4;84-90.
  4. A scanning electron microscopic investigation of principal and accessory foramina on the root surfaces of human teeth: thoughts about endodontic pathology and therapeutics. J Endod. 1983; 9:275-81.
  5. Dye ingress in molars: furcation to chamber floor. J Endod. 1993; 19:293-6.
  6. Periodontal-endodontic consideration. Principles and practice of endodontics. 3rd ed. Philadelphia: WB Saunders Co; 2002. p. 466-84.
  7. Diagnosis, prognosis and decision-making in the treatment of combined periodontal-endodontic lesions. Periodontol 2000. 2004; 34:165-203.
  8. Endodontic therapy. 4th ed. St. Louis: The CV Mosby Co; 1989. p. 355-60.
  9. Root perforations: classification and treatment choices based on prognostic factors. Endod Dent Traumatol. 1996; 12:255-64.
  10. Fatigue root fracture: a spontaneous root fracture in non-endodontically treated teeth. Br Dent J. 1997; 182:261-6.
  11. Vertical root fracture in endodontically versus nonendodontically treated teeth: a survey of 315 cases in Chinese patients. Oral Surg, Oral Med, Oral Pathol, Oral Radiol, Endod. 1999; 87:504-7.
  12. Prevalence of vertical root fractures in extracted endodontically treated teeth. Int Endod J. 1999; 32:283-6.
  13. A study of the presence of accessory foramina and the topography of molar furcations. Oral Surg, Oral Med, Oral Pathol. 1974; 38: 451-5.
  14. Frequency, location, and direction of the lateral, secondary, and accessory canals. J Endod. 1975; 1:361-6.
  15. Pulpitis-induced interradicular periodontal changes in experimental animals. J Periodontol. 1967; 38:124.
  16. The effects of surgical exposure of dental pulp in germ-free and conventional laboratory rats. Oral Surg, Oral Med, Oral Pathol. 1965; 20:340-9.
  17. The diversity of periodontal spirochetes by 16S rRNA analysis. Oral Microbiol Immunol. 2000; 15:196-202.
  18. Checkerboard DNA-DNA hybridization analysis of endodontic infections. Oral Surg, Oral Med, Oral Pathol, Oral Radiol, Endod. 2000; 89:744-8.
  19. Typing of herpes simplex virus from human periodontium. Oral Microbiol Immunol. 2001; 16:63-4.
  20. Isolation of yeasts and enteric bacteria in root-filled teeth with chronic apical periodontitis. Int Endod J. 2001; 34:429-34.
  21. Cytomegalovirus and Epstein-Barr virus active infection in periapical lesions of teeth with intact crowns. J Endod. 2003; 29:321-3.
  22. The influence of endodontic infection on periodontal status in mandibular molars. J Periodontol. 1998; 69:1392-6.
  23. Relationship between periapical and periodontal status. A clinical retrospective study. J Clin Periodontol. 1993; 20:117-23.
  24. Endodontic pathogens in periodontal disease augmentation. J Clin Periodontol. 1995; 22:598-602.
  25. A histological evaluation of the human pulp in teeth with varying degrees of periodontal disease. J Endod, 1979; 5:242-53.
  26. Effect of root canal status on periodontal healing after surgical injury in dogs. Endod Dent Traumatol. 1994; 10:77-82.
  27. In vitro bacterial penetration of coronally unsealed endodontically treated teeth. J Endod. 1990; 16:566-9.
  28. Bacterial invasion of pulpal dentin wall in vitro. J Dent Res. 1982; 61:435-8.
  29. Root canal dentinal tubule disinfection. J Endod. 1990;16:207-10.
  30. Inhibition of bacterial growth under composite restorations following GLUMA pretreatment. J Dent Res. 1989; 68:491-5.
  31. Long term evaluation of retrograde root filling with dentin bonded resin composite. J Endod. 1996; 22:90-3.
  32. Apical and coronal seal of roots obturated with a dentine bonding agent and resin. Int Endod J. 1996; 29:76-83.
  33. Bacterial penetration and proliferation in root canal dentinal tubules after applying dentin adhesives in vitro. J Endod. 2001; 27:398-400.
  34. The correlation between positive cultures and the prognosis of root canal therapy after pulpectomy. Odontol Revy. 1965; 16:193-203.
  35. Experimental periodontitis in the beagle dog. J Periodontal Res. 1973; 8:1-10.
  36. Longitudinal study of experimentally induced periodontal disease in Macaca arctoides: relationship between microflora and alveolar bone loss. Infect Immunol. 1979; 23:260-9.
  37. Bacteriologic evaluation of the efficacy of mechanical root canal instrumentation in endodontic therapy. Scand J Dent Res. 1981; 89:321-8.
  38. The antibacterial action of sodium hypochlorite and EDTA in 60 cases of endodontic therapy. Int Endod J. 1985; 18:35-40.
  39. The antibacterial effect of camphorated paramonochlorophenol, camphorated phenol and calcium hydroxide in the treatment of infected root canals. Endod Dent Traumatol. 1985; 1:170-5.
  40. In-vitro infection and disinfection of dentinal tubules. J Dent Res. 1987; 66:1375-9.
  41. A laboratory study of the effect of calcium hydroxide mixed with iodine or electrophoretically activated copper on bacterial viability in dentinal tubules. Int Endod J. 2002; 35:522-6.
  42. Antibacterial efficacy of new slow release device in vitro. J Endod. 2003;29:175-82.
  43. Endodontic medicaments. In: Smith DC, Williams DF, editors. Biocompatibility of dental materials. Boca Raton, FL: CRC Press; 1982. p. 223-57.
  44. On duration of the antibacterial efficiency of four antiseptics used in root canal treatment in situ. Sven Tandlak Tidskr. 1958; 51:1-6.
  45. Dentinal tubule disinfection using three calcium hydroxide formulations. J Endod. 2005; 31:50-2.
  46. Surface interaction of dentine adhesive materials. Oper Dent. 1992; 5(suppl):81-94.
  47. Effect of HEMA on bonding to dentin. Dent Mater. 1992; 8:125-30.
  48. The hybrid layer: a resin-dentin composite. Proceed Finn Dent Soc. 1992; 88(suppl 1):225-42.
  49. Clinical, radiographic and histologic perspectives on success and failure in endodontics. Dent Clin North Am. 1992; 36:379-93.
  50. Adaptation of injected thermoplasticized gutta-percha in the absence of the dentinal smear layer. Int Endod J. 1993; 26:87-92.
  51. Coronal leakage as a cause of failure in root-canal therapy: a review. Endod Dent Traumatol. 1994; 10:105-8.
  52. Stereomicroscopic and scanning electron microscopic study of roots obturated with vertically condensed gutta-percha, epoxy resin cement, and dentin bonding agent. J Endod. 1998; 24:397-400.
  53. Comparison between gutta-percha and resilon removal using two different techniques in endodontic retreatment. J Endod. 2006; 32:362-4.
  54. Dentinal bonding reaches the root canal system. J Esthet Restor Dent. 2004; 16:348-54.
  55. Periapical inflammation after coronal microbial inoculation of dog roots filled with gutta-percha or resilon. J Endod. 2005; 31:91-6.
  56. Fracture resistance of roots. J Am Dent Assoc. 2004;135:646-52. Erratum in: J Am Dent Assoc. 2004; 135:868.
  57. An evaluation of microbial leakage in roots filled with a thermoplastic synthetic polymer-based root canal filling material (Resilon). J Endod. 2004;30:342-7.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.