Ichraq Oulghazi, Mounsif Mariam, Fennich Maria, El Yamani Amal
Department of Prosthodontics, Mohammed V University, Rabat, MAR.
Department of Periodontology, Mohammed V University, Rabat, MAR.
Cureus. 2025 Jun 10;17(6):e85715. doi: 10.7759/cureus.85715. eCollection 2025 Jun.
Endodontic-periodontal lesions involve a pathological connection between the pulpal and periodontal tissues, often complicating both diagnosis and treatment. Accurate identification and classification are essential to determine an appropriate therapeutic approach. This case report describes the multidisciplinary management of a grade 3 endo-periodontal lesion without root damage. A 43-year-old female presented with pain and swelling in the left mandibular first molar. Clinical and radiographic findings indicated a failed root canal treatment, deep periodontal pockets, and furcation involvement. After emergency drainage of a periodontal abscess, endodontic retreatment was initiated with sodium hypochlorite irrigation and calcium hydroxide medication, followed by canal obturation and coronal restoration. Non-surgical periodontal therapy was also performed. Over a three-year follow-up, clinical and radiographic evaluations confirmed resolution of symptoms and periodontal stability. This case highlights the importance of a sequential, combined approach and emphasizes the need for a proper coronal seal to ensure long-term success in managing complex endo-periodontal lesions.
牙髓-牙周联合病变涉及牙髓组织与牙周组织之间的病理连接，常常使诊断和治疗变得复杂。准确的识别和分类对于确定合适的治疗方法至关重要。本病例报告描述了一例无牙根损伤的3级牙髓-牙周联合病变的多学科管理。一名43岁女性患者，左下颌第一磨牙出现疼痛和肿胀。临床和影像学检查结果表明根管治疗失败、牙周袋深及根分叉病变。在对牙周脓肿进行紧急引流后，开始进行根管再治疗，采用次氯酸钠冲洗和氢氧化钙药物治疗，随后进行根管充填和冠部修复。同时也进行了非手术牙周治疗。经过三年的随访，临床和影像学评估证实症状已缓解且牙周稳定。本病例强调了序贯联合治疗方法的重要性，并强调需要进行适当的冠部封闭以确保在处理复杂的牙髓-牙周联合病变时取得长期成功。
