Endodontic-periodontic bifurcation lesions: a novel treatment option

J Contemp Dent Pract. 2008 May 1;9(4):107-14.

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.

MeSH terms

  • Anti-Infective Agents, Local / therapeutic use
  • Calcium Hydroxide / therapeutic use
  • Dental Pulp Diseases / complications*
  • Dentin-Bonding Agents / therapeutic use
  • Epoxy Resins / therapeutic use
  • Follow-Up Studies
  • Furcation Defects / etiology
  • Furcation Defects / therapy*
  • Gutta-Percha / therapeutic use
  • Humans
  • Iodine / therapeutic use
  • Periapical Diseases / etiology
  • Periapical Diseases / therapy*
  • Periodontal Abscess / etiology
  • Periodontal Abscess / therapy
  • Potassium Iodide / therapeutic use
  • Resin Cements / therapeutic use
  • Root Canal Filling Materials / therapeutic use
  • Root Canal Irrigants / therapeutic use
  • Root Resorption / etiology
  • Root Resorption / therapy
  • Wound Healing / physiology

Substances

  • Anti-Infective Agents, Local
  • Clearfil SE Bond
  • Dentin-Bonding Agents
  • Epoxy Resins
  • Resin Cements
  • Root Canal Filling Materials
  • Root Canal Irrigants
  • epoxy resin-based root canal sealer
  • Potassium Iodide
  • Gutta-Percha
  • Iodine
  • Calcium Hydroxide