Combined periodontic-endodontic lesions

Combined periodontic-endodontic lesions are localized, circumscribed areas of bacterial infection originating from either dental pulp, periodontal tissues surrounding the involved tooth or teeth or both.

[1] Combined periodontic-endodontic lesions take the form of abscesses and can originate from either or both of two distinct locations[1] and may be informally subclassified as follows:[citation needed] Neither the prognosis, treatment nor expected treatment outcome depend on the source of the infection.

[2] A combined lesion may also be the result of a fractured tooth.

Treatment includes conventional endodontic therapy followed by conventional periodontal therapy.

If the lesion is deemed too severe for treatment, the involved tooth may require extraction.

Periapical readiograph of lower right teeth, showing a large carious lesion in the distal of the lower right second molar. The same tooth also has an extensive periodontal defect. At this stage, without further information, it is difficult to tell which process has occurred first and lead to the death of the pulp.