Successful Multidisciplinary Management of an Endodontic‐Periodontal Lesion Associated With a Palato‐Radicular Groove: A Case Report

Katwal, Diksha; Fiorica, Jennifer K.; Bleuel, Jane; Clark, Stephen J.

doi:10.1002/cap.10079

Cited by 8 publications

(6 citation statements)

References 11 publications

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“…With accurate assessment of the etiology of the defect, patient education, and a multidisciplinary approach, teeth with a palatal radicular may be retained with a stable outcome for years. 53,54 Many studies indicated that combined endodontic and periodontal therapy is required for successful healing of endo-perio lesions. 55,56 Schilder 57 postulated that either endodontic treatment or periodontal pathology will not produce favorable outcomes.…”

Section: Discussionmentioning

confidence: 99%

<p>Treatment of an Endo-Perio Lesion with Ozone Gas in a Patient with Aggressive Periodontitis: A Clinical Case Report and Literature Review</p>

Makeeva

Даурова

Byakova

et al. 2020

CCIDE

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The pulp and periodontium have obvious relationships that have been described in many studies. Pulp infections may affect periodontal tissues and vice versa. Teeth with endo-perio lesions have a worse prognosis than isolated endodontic or periodontal lesions. Elimination of endodontic and periodontal infections is essential for successful treatment, so co-operation between endodontists and periodontists is necessary. In this clinical case, a 44-year-old male presented with primary periodontal disease with secondary endodontic involvement in his lower right canine because of aggressive periodontitis. There was 10 mm of clinical attachment loss and 8 mm periodontal pocket mesial from the tooth and bone radiolucency periapical and lateral from the root. Periodontal therapy was followed by endodontic treatment. Periodontal therapy included root scaling and planing, treatment of the periodontal pocket with ozone gas, systemic antibiotics, oral hygiene instructions, and chlorhexidine rinsing. Endodontic therapy included root canal instrumentation with rotary endodontic files, irrigation, root canal treatment with ozone gas, and obturation with lateral compaction. Radiographs at a 6-month follow-up appointment showed complete healing of the periapical lesion and alveolar bone lateral to the root. Using an interdisciplinary approach to treat endo-perio lesions provides favorable clinical outcomes. Ozone therapy is beneficial for the successful treatment of endo-perio lesions with narrow periodontal pockets in patients with aggressive periodontitis and poor prognosis.

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Section: Discussionmentioning

confidence: 99%

<p>Treatment of an Endo-Perio Lesion with Ozone Gas in a Patient with Aggressive Periodontitis: A Clinical Case Report and Literature Review</p>

Makeeva

Даурова

Byakova

et al. 2020

CCIDE

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“…There are shortterm cases dealing with these teeth in a multidisciplinary manner. 16 However, there is a dearth of case reports with long-term success. This case illustrates the advantages of saving a guarded tooth in the maxillary esthetic zone in a young patient with an apparent "hopeless" tooth.…”

Section: Discussionmentioning

confidence: 99%

“…Teeth with a shallower groove and less depth of the groove down the root of the tooth have a better prognosis. There are short‐term cases dealing with these teeth in a multidisciplinary manner 16 . However, there is a dearth of case reports with long‐term success.…”

Section: Discussionmentioning

confidence: 99%

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Interdisciplinary management of a maxillary central incisor with a palato‐radicular groove: A case report with 27 years follow‐up

Mathews

Hansen

2021

J Esthet Restor Dent

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Objective: The palato-radicular groove (PRG) is caused by a developmental anomaly, genetically determined, whereby an in-folding of the enamel organ and Hertwig's epithelial root sheath occurs. The depth and length of the groove determine the prognosis for the tooth. The interdisciplinary team formulated a treatment plan to save this tooth for this 8-year-old patient. The goal was to prolong the life of the tooth until his growth was completed and a more permanent tooth replacement could be considered if the tooth failed.Clinical considerations: This patient had #8 with a very deep palatal groove extending from the CEJ to the apex of the tooth, causing a 12 mm periodontal pocket with suppuration. Endodontic treatment, periodontal regeneration, and orthodontics were done to prolong the life of the tooth and preserve the bone for future tooth replacement if the tooth failed and needed to be extracted. The tooth survived for 11 years before the pocketing recurred due to the deep groove. The tooth was extracted and replaced with an implant. Conclusion:Teeth with a PRG present multiple challenges depending on the depth and length of the groove. An accurate diagnosis of the endodontic and periodontal status of the tooth is critical. Teeth with very long and deep grooves make the case more difficult to treat endodontically and periodontally. The tooth had a very poor prognosis; however, it was saved for an extended period of time with a well thought out interdisciplinary treatment plan. The advantages of maintaining this tooth, in lieu of extraction at age 8, will be elucidated. Clinical significance: Retaining guarded teeth in the maxillary esthetic zone for an 8-year-old patient, has many advantages. It can simplify and enhance future treatment results. The patient retained this central incisor through the formative years. It simplified the orthodontic treatment and implant treatment. The importance of keeping "roots in the bone" to preserve the alveolar bone has many advantages for future treatment options.

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“…To the authors' knowledge, this is the first study analyzing this aspect. There have been several case reports demonstrating different approaches to treating these lesions [15][16][17][18][19]. Some showed success but only in a few patients and most of them referred only to single-rooted teeth.…”

Section: Discussionmentioning

confidence: 99%

Effect of endodontic treatment on periodontal healing of grade 3 endo-periodontal lesions without root damage in periodontally compromised patients—a retrospective pilot study

et al. 2020

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Objectives There is little evidence about the effect of different treatment protocols for grade 3 endo-periodontal lesions without root damage in patients with periodontitis according to the new classification of periodontal disease. The aim of this study is to evaluate the impact of endodontic treatment on the achievement of periodontal healing. Materials and methods Teeth with the initial diagnosis endo-periodontal lesion without root damage grade 3, treated with a standardized endodontic treatment protocol, were included in this study. A retrospective analysis was performed to assess the impact on periodontal healing by evaluating probing pocket depth (PPD), clinical attachment gain (CAL), and periapical index score (PAI). Results Nineteen teeth and 13 patients were included. A mean reduction of 3.19 ± 3.41 mm in PPD was recorded. The mean CAL gain was 2.33± 3.75 mm. Five teeth (45.4%) showed an improvement of PAI and were classified as treatment success. Conclusions The results failed to show a highly predictable treatment outcome for endo-periodontal lesion grade 3 without root damage in patients with periodontitis. However, endodontic therapy alone resulted in treatment success for some of the teeth, which would otherwise have had a poor prognosis. Clinical relevance Endo-periodontal lesions can often be challenging for dentists in daily clinical practice. To date, there is not much evidence for practitioners to rely on. Therefore, this study aims to strengthen the evidence for the management and treatment of endo-periodontal lesions. Although the outcome is not highly predictable yet, teeth with the initial diagnosis endo-periodontal lesion without root damage grade 3 can benefit from an endodontic treatment.

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Successful Multidisciplinary Management of an Endodontic‐Periodontal Lesion Associated With a Palato‐Radicular Groove: A Case Report

Cited by 8 publications

References 11 publications

<p>Treatment of an Endo-Perio Lesion with Ozone Gas in a Patient with Aggressive Periodontitis: A Clinical Case Report and Literature Review</p>

<p>Treatment of an Endo-Perio Lesion with Ozone Gas in a Patient with Aggressive Periodontitis: A Clinical Case Report and Literature Review</p>

Interdisciplinary management of a maxillary central incisor with a palato‐radicular groove: A case report with 27 years follow‐up

Effect of endodontic treatment on periodontal healing of grade 3 endo-periodontal lesions without root damage in periodontally compromised patients—a retrospective pilot study

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