Management of Endo-periodontal Lesion of Mandibular Anterior Teeth: A Case Report
Souksida Xaykhambanh *
Department of Endodontic, Faculty of Dentistry, University of Health Sciences, Laos.
Chanthavisao Phunthanalay
Faculty of Dentistry, University of Health Sciences, Laos.
Chanvilay Soukhaseam
Faculty of Dentistry, University of Health Sciences, Laos.
Sombath Atsaphangthong
Setthathirath Hospital, Laos.
Soulideth Inthakone
Faculty of Dentistry, University of Health Sciences, Laos.
Thiphavanh Vongxay
Faculty of Dentistry, University of Health Sciences, Laos.
Patay Vongsathiane
Faculty of Dentistry, University of Health Sciences, Laos.
Daovone Homboutsavong
Faculty of Dentistry, University of Health Sciences, Laos.
Kamkeo Boupha
Faculty of Dentistry, University of Health Sciences, Laos.
*Author to whom correspondence should be addressed.
Abstract
Endo-periodontal lesions remain a challenging clinical entity due to the complex anatomical and pathological relationship between the pulp and the periodontium. Case reports highlighting sequential endodontic and periodontal management can help clinicians understand appropriate treatment planning and prognosis. This manuscript attempts to reinforce the concept of addressing the endodontic component prior to periodontal intervention. With appropriate revisions, the case could contribute useful clinical insight for general practitioners and postgraduate students. The intimate physiological connection between the periodontium and the dental pulp significantly increases the complexity of managing combined endo-periodontal lesions. Achieving a successful outcome requires the total eradication of pathogens from both the periodontal and endodontic systems. These lesions are frequently encountered in clinical settings; if left unaddressed, an endodontic infection will inevitably compromise the periodontium, and vice versa. This report presents a tooth with combined endodontic-periodontal involvement treated with a staged approach: first root canal therapy, then flap surgery. Post-operative evaluation at nine months revealed significant clinical attachment gain.
Keywords: Endo–perio lesions, root canal treatment, periodontal open flap, prognosis