Giving the Endo-Perio Relationship a “Makeover”:
The pulp and periodontium are closely related through their embryonic,
anatomic and functional interrelationships. Though endodontic-periodontal
lesions are encountered occasionally, they are estimated to cause 50% of tooth
morbidity. Up till now, endodontic-periodontal lesions pose a difficulty for the
clinician to diagnose, establish a treatment plan and determine a prognosis for
the involved tooth.
The lesions have a varied pathogenesis which range from quite simple to
relatively complex. It is of extreme importance for the dentist to distinguish all
the possible routes of communication between the pulp and the periodontium
which act as possible “bridges” for the microorganisms, enabling the spread of
the infection from one site to another. Through this knowledge, the dentist will
be able to achieve the precise diagnosis and suitable treatment, resulting in a
greater chance of success in the treatment of the endodontic-periodontal lesions.
Owing to the complexity of these infections, both endodontic and periodontal
treatment has to be done consecutively and care has to be taken to avoid cross
Accordingly, the management of endodontic-periodontal lesions requires an
interdisciplinary approach with a good collaboration between endodontists and
By the end of this debate, participants should be able to:
- Differentiate between the origins of the endodontic-periodontal lesions
and get acquainted with the newer classifications.
- Understand the sequential approach for management of different cases.
- Appreciate the recent scientific concepts and regenerative approaches
applied in the treatment of endodontic-periodontal cases.