Grudianov A I, Makeeva M K, Piatgorskaia N V
Vestn Ross Akad Med Nauk. 2013(8):34-6.
A combination ofperiodontitis and pulp or periapical tissues inflammation in one tooth is known as endo-periodontal lesions. Such kind of lesion is serious problem of modern dentistry. It was found that pathogenic microflora of periodontal pocket and root canal of tooth with eno-perio lesion is almost the equal and consist of anaerobic microorganisms. Pathogenic effects have not only microorganisms but also their life products. Apical foramen, lateral and additional canals are physiological ways for pathogens migration. Inflammatory processes in these structures complicate each other. Lack of information among dentists about treatment possibilities of endo-perio lesions is a main reasons of extraction such kind of teeth. Simultaneous elimination of pathogens both from periodontal pocket and root canal is a key factor for effective treatment. Periodontal status is main factor for prognosis of tooth with endo-perio lesion, because of it treatment of endo-perio lesions should consist of two stages: infection elimination and regeneration of tooth-supported structures.
一颗牙齿中牙周炎与牙髓或根尖周组织炎症同时存在的情况被称为牙髓牙周联合病变。这类病变是现代牙科领域的严重问题。研究发现，患有牙髓牙周联合病变的牙齿的牙周袋和根管中的致病微生物几乎相同，且均由厌氧微生物组成。致病作用不仅来自微生物，还来自它们的代谢产物。根尖孔、侧支根管和副根管是病原体迁移的生理途径。这些结构中的炎症过程相互影响。牙医对牙髓牙周联合病变治疗可能性的了解不足是拔除这类牙齿的主要原因。同时清除牙周袋和根管中的病原体是有效治疗的关键因素。牙周状况是牙髓牙周联合病变牙齿预后的主要因素，因此牙髓牙周联合病变的治疗应包括两个阶段：消除感染和牙齿支持结构的再生。
