Jаffaя яaza Syзd Page 1

PULPOPERIODONTAL PROBLEMS periodontitis by extension of inflammation from the gingiva into deeper periodontal tissues. periodontitis can also be have entered the periodontal ligament either through the apical foramen

or through the lateral canals. “retrograde periodontitis.”

“retrograde pulpitis” can also occur as a result of periodontal disease and periodontal treatment

Jаffaя яaza Syзd Page 2

PATHWAYS OF COMMUNICATION BETWEEN PULP AND PERIODONTIUM It can be classified into three categories: 1. PATHWAYS OF DEVELOPMENTAL ORIGIN. • Apical foramen • Accessory canals and lateral canals. • Developmental grooves. • Enamel projections and pearls at the cervical portion. 2. PATHWAYS OF PATHOLOGIC ORIGIN • Tooth fracture (vertical). • Idiopathic resorption can be: a. Internal: From the pulp to the surface of the tooth. b. External: From the external surface of the root to the pulp. • Both internal and external resorption produces communication. • Loss of cementum due to external irritants. 3. PATHWAYS OF IATROGENIC ORIGIN • Exposure of dentinal tubules following root planing. • Accidental lateral perforation during endodontic procedure. • Root fracture due to endodontic procedure.

Jаffaя яaza Syзd

Page 3

Jаffaя яaza Syзd

Page 4

Jаffaя яaza Syзd

EFFECTS OF PULPAL DISEASE ON THE PERIODONTIUM The three major causes of pulpal inflammation are: 1. Instrumentation during periodontal, restorative or 2. Progression of dental caries. 3. Tooth fractures.

THE PERIODONTIUM

The three major causes of pulpal inflammation are:

1. Instrumentation during periodontal, restorative or prosthetic procedures.

Page 5

Jаffaя яaza Syзd

ENDOPERIOLESIONS CLASSIFICATION

Page 6

Jаffaя яaza Syзd

Page 7

Jаffaя яaza Syзd Page 8

MICROBIOLOGICAL FINDINGS B. forsythus, P. gingivalis T. denticola, Fusobacteria, Spirochetes, Wolinella and Peptostreptococcus have been found in endoperio lesions DIAGNOSIS Traditional diagnostic aids including, radiographic analysis with gutta percha tracing, Periodontal probing, fiberoptic illumination to rule out whether a fracture exists, vitality test, percussion tests