2 APPROACHES TO THE TREATMENT OF TRUE COMBINED PERIODONTAL-ENDODONTALLESIONS

Periodontal endodontal lesions present a difficult diagnostic and trea tment challenge to the clinician and treatment often requires a combin ed therapeutic effort. Both endodontal and periodontal surgical proced ures may be indicated for access and treatment of these lesions. This case report presents an early onset periodontitis patient with bilater al periodontal-endodontal lesions on mandibular first molars. Treatmen t included apical surgery followed by repeated scaling and root planin g on one tooth and root canal obturation followed by a periodontal bon e grafting procedure on the other. Both procedures resulted in clinica l attachment gain as well as radiographic evidence of alveolar bone ga in. This case report once again demonstrates that proper diagnosis fol lowed by removal of etiologic factors and nonsurgical therapy or perio dontal regenerative procedures can restore health and function in case s of severe attachment loss.