Possibilities of endodontic therapy of endodonic-periodontal lesions

Abstract

Intoduction. Endoperiodontal lesions are frequent in clinical practice and may require complex therapy. It is very important to determine differential diagnosis and the origin of the lesion, because the treatment plan is based on aetiology and stadium of the development of the lesion. Objective. The aim of this clinical study was to analyze the efficacy of endodontic treatment in different types of endodontic- periodontal lesions. Methods. Thirty patients and 42 teeth with diagnosed endoperiodontal lesions were included in the study and divided in two groups. Vital pulp therapy was applied to 18 vital teeth where the diagnosis was perio-endodontic lesions. The therapy of infected canal system was applied to 24 teeth with endodontic- periodontal or combined lesions. Standard endodontic procedure consisted of cleaning and shaping of the root canal system and between sessions filling with calcium-hydroxide paste. Obturation was made by lateral compact of the guttapercha and Apexit paste. Efficiency was evaluated clinically and radiographically three, six and twelve months later. Results. Radiographic and clinical follow-up showed a significant radiographic improvement and absence of subjective symptoms in a very high percentage of the treated vital and avital teeth. The results of this study showed that in the observation period of 12 months endodontic therapy was successful in 88.89% of vital teeth, and in the group of avital teeth the percentage was 91.67%. Conclusion. Endodontic treatment of the endoperiodontal lesions was sufficient and it was the basic condition to achieve a complete healing of endodontic-periodontal lesions. Such therapy ensures significant improvement or even complete healing of both types of lesions, of endodontic and periodontal origin.

Uvod. Endoparodontalne lezije su značajan patološki entitet čije je lečenje vrlo zahtevno i složeno. Cilj rada. Cilj rada je bio da se kliničkim istraživanjima ispita efikasnost endodontskog lečenja endoparodontalnih i paroendodontalnih lezija. Metode rada. Klinička studija je obuhvatila 30 pacijenata, odnosno 42 zuba kod kojih je postavljena dijagnoza endoparodontalnih lezija. Uzorci zuba su svrstani u dve grupe: prva je obuhvatila 18 vitalnih zuba s paroendodontalnim lezijama lečenim biopulpektomijom, dok su drugu grupu činila 24 zuba s avitalnom pulpom i endoparodontalnim i kombinovanim lezijama kod kojih je primenjena terapija inficiranih kanala korena. Konačna opturacija kanala korena zuba u obe grupe uzoraka vršena je tehnikom lateralne kompakcije gutaperke i primenom apeksit- paste (Apexit ®). Efikasnost lečenja procenjena je na kliničkim i radiografskim kontrolnim pregledima tri meseca, šest i 12 meseci nakon konačne opturacije. Rezultati. Endodontsko lečenje je u posmatranom dvanaestomesečnom periodu bilo uspešno kod 88,89% vitalnih, odnosno 91,67% avitalnih zuba. Zaključak. Endodontsko lečenje je najčešće dovoljan, ali i osnovni preduslov za potpuno izlečenje endoparodontalnih lezija.