A NEW APPROACH TO THE TREATMENT OF TRUE-COMBINED ENDODONTIC-PERIODONTIC LESIONS BY THE GUIDED TISSUE REGENERATION TECHNIQUE

Clinicians often have difficulty in the diagnosis and treatment of the combined endodontal and periodontal (endo-perio) lesion. A case of an endoperio true-combined lesion on a maxillary premolar was first trea ted with conventional endodontic therapy. Periodontal surgery was then completed, which included scaling and root planing and apical curetta ge on the tooth. The facial bony defect was then filled with a decalci fied freeze-dried bone allograft mixed with tetracycline powder. A non resorbable Teflon membrane was then used to cover the bone material an d the periodontal flap sutured over this. This combined treatment resu lted in minimal probing depth (2 mm), maximal clinical attachment gain (8 mm), as well as radiographic evidence of alveolar bone gain. This case report demonstrates that proper diagnosis, followed by removal of etiological factors and utilizing the guided tissue regeneration tech nique combined with osseous grafting, will restore health and function to a tooth with severe attachment loss caused by an endo-perio lesion .