Zubery Y, Kozlovsky A
Department of Periodontics, University of Texas Health Science Center, San Antonio.
J Endod. 1993 Aug;19(8):414-6. doi: 10.1016/S0099-2399(06)81508-6.
Periodontal endodontal lesions present a difficult diagnostic and treatment challenge to the clinician and treatment often requires a combined therapeutic effort. Both endodontal and periodontal surgical procedures may be indicated for access and treatment of these lesions. This case report presents an early onset periodontitis patient with bilateral periodontal-endodontal lesions on mandibular first molars. Treatment included apical surgery followed by repeated scaling and root planing on one tooth and root canal obturation followed by a periodontal bone grafting procedure on the other. Both procedures resulted in clinical attachment gain as well as radiographic evidence of alveolar bone gain. This case report once again demonstrates that proper diagnosis followed by removal of etiologic factors and nonsurgical therapy or periodontal regenerative procedures can restore health and function in cases of severe attachment loss.
牙周牙髓联合病变给临床医生带来了诊断和治疗上的难题，治疗通常需要综合治疗手段。牙髓和牙周手术都可能用于这些病变的探查和治疗。本病例报告介绍了一名早期牙周炎患者，其下颌第一磨牙双侧出现牙周牙髓联合病变。治疗包括对一颗牙齿进行根尖手术，随后反复进行龈下刮治和根面平整；对另一颗牙齿进行根管充填，随后进行牙周骨移植手术。两种治疗方法均使临床附着获得增加，并在影像学上显示牙槽骨有增加。本病例报告再次证明，在严重附着丧失的病例中，通过正确诊断，去除病因，并进行非手术治疗或牙周再生手术，可以恢复健康和功能。
