Periodont and endodont can show pathological coherencies that result in perio-endodontic lesions. What is the best diagnostic approach? Which therpeutical concept is the best for which situation? Appl. Professor Dr. Stefan Fickl, University of Würzburg/Germany, shares the answers. Periodontal-endodontal interdependencies consist as dentinal tubules, lateral and furcational root canals and in the apical region. Also iatrogen interdependencies like a via falsa or root fractions can lead to a communication between endodont and periodont and therefore to a perio-endo-lesion.
A vital pulpa is able to defend itself periodontal-pathogen bacteria and their secretion agents and shelter from a infection, therefore perio-endo-lesions are rather rare. Even an endodontic infection probably doesn't secrete enough bacteria to cause an infection of a healthy periodont. More often there are coincidences where separate infections take place in the periodont and the endodont which appear like perio-endo-lesions. The therapy should focus on the dominating disease either by a periodontal therapy or by a root canal therapy.