The interrelationship between periodontal and endodontic disease has a
roused much speculation, confusion, and controversy. Pulpal and period
ontal problems are responsible for more than 50% of tooth mortality to
day. Diagnosis is often difficult since these diseases have been studi
ed primarily as separate entities, The toxic substances of the pulp ma
y initiate periodontal defects through canal ramifications and patent
dentinal tubules, thus impairing wound healing in regenerative procedu
res. Although no studies exist addressing the direct effect of pulpal
infection on the outcome of guided tissue regeneration (GTR) procedure
s, several studies do indicate that pulpal status may play a significa
nt role toward the end results of GTR. This review article discusses t
he potential influence of endodontic treatment on the long-term outcom
es of GTR. Potential pathways between the pulp and periodontal ligamen
t, which may be responsible for the failure of the regeneration of new
periodontal attachment apparatus, are explored, Examination and revie
w of the clinical and research findings in the literature relating to
perio-endo lesions are made to demonstrate that a negative influence m
ay exist between GTR outcomes and the status of the pulp.