A RELATIONSHIP BETWEEN ENDODONTIC AND PERIODONTAL LESION ANALYSIS AND MANAGEMENT DECISION ANALYSIS: AN UPDATE

The relationship between periodontal and endodontic disease has been controversial aspect for more than a century. Differentiating between these periodontal and endodontic disease is very difficult due their developmental, embryonic, anatomic and functional similarities. Nature pain is often considered as the first clue which should be supported by the radiographic and clinical evaluation for the correct diagnosis of the condition. Aim: The aim of this review was to develop a decision tree for easier and accurate diagnosis of periodontal and endodontic disease. A brief PubMed search was performed on endodontic and periodontal lesion using MESH terms endo-perio lesion, diagnosis of endoperio lesion, decision making of endo-perio lesion. In addition some websites and local guidelines were screened. By following the correct and appropriate diagnostics methods, accurate diagnosis of Endodontic -Periodontal disease can be done and the treatment for the particular condition could be achieved. Conclusion: With a decision tree, the diagnosis and pharmacological management of the pulpal and periapical diseases becomes easier for the dentist in regular clinical practice. A decision tree and a flow chart for daily practice which should be started up as soon as the patient presents with pain or swelling due to pulpal or periodontal periapical pathology. In this aspect active management of the infection can be done with sound knowledge on the endodontic periodontal lesions. Dentists are likely to encounter lesions that have both periodontal and endodontic aetiological components the so called perio-endo lesions. A thorough examination with appropriate investigations remains pivotal to diagnosing a perio-endo lesion. Correct diagnosis of such lesions is therefore important as it enables the most suitable clinical management to be treatment planned. It is still recommended, that for the treatment of perio-endo lesions, initial endodontic therapy is completed.