Microbiological Profile in Endodontic-periodontal Lesion

Abstract

Endodontic-periodontal lesion is a clinical manifestation of the pathologic intercommunication between pulpal and periodontal tissues. In general, these lesions are multifaceted in nature and can have a varied pathogenesis. Fundamental to our understanding of the pulpoperiodontal lesions is the key role of the pathogenic ecosystem that exists within this complex structure. Evidence suggests that there exists a wide range of microbial species in the periapical and periodontal tissues and that their concurrent pathogenesis is constantly linked to the bacterial interrelations between the two tissue types. Understanding the microbial involvement is of utmost significance as it offers a rationale for differential diagnosis and subsequent management of such lesions. This review has attempted to provide a basic insight on the microbiome or the microbial flora entailed in the bidirectional pathogenesis of endodontic-periodontal lesions. How to cite this article Rajasekaran M, Nainar DA, Alamelu S, KV Arun. Microbiological Profile in Endodontic-periodontal Lesion. J Oper Dent Endod 2016;1(1):25-29.

A Multi-Disciplinary Approach in the Management of Endo-Perio Lesions: A 4-year Follow-Up Case Report

“…The pulp and periodontal tissue are biological complexes that are closely related uniquely [ 1 ]. Many physiologic communication paths exist, such as through the exposed dentinal tubules, lateral and accessory canals, or apical foramen [ 1 , 2 ]. Those tissues can be infected individually or combined, and when both systems are involved, they are termed endodontic–periodontal lesions (EPLs) [ 1 ].…”

“…The exposure of dentinal tubules on the missing parts of the cementum will allow the bacterial invasion to the tubules and increase the likelihood of cumulative damage to the pulp, leading to retrograde pulpitis [ 4 ]. Periodontal disease can progress apically and involve the apical foramen, causing pulpal necrosis [ 2 , 4 ].…”

“…The merging of two independent lesions forms it: the periapical lesion originating from the necrosis pulp and the periodontal lesion progressing apically [ 3 , 4 ]. Lastly, EPL can also develop through nonphysiological pathways, such as iatrogenic root canal perforations and vertical root fractures (VRFs) [ 1 , 2 ]. Through these pathways, organisms can spread from the infected pulp to the healthy periodontium or from the periodontal lesion to a vital pulp [ 1 , 2 ].…”

“…Lastly, EPL can also develop through nonphysiological pathways, such as iatrogenic root canal perforations and vertical root fractures (VRFs) [ 1 , 2 ]. Through these pathways, organisms can spread from the infected pulp to the healthy periodontium or from the periodontal lesion to a vital pulp [ 1 , 2 ].…”