J Dent Rehabil Appl Sci.  2019 Mar;35(1):46-54. 10.14368/jdras.2019.35.1.46.

Guided tissue regeneration therapy after root canal therapy for long standing periodontal-endodontic combined lesion in the mandibular anterior area: case report

• Kwon EY
• Jung KH
• Kim SY
• Jeon HM
• Choi YK
• Joo JY

• KMID: 2450925
• DOI: http://doi.org/10.14368/jdras.2019.35.1.46

Abstract

When inflammatory products are found in both periodontal and pulpal tissues simultaneously, a periodontal-endodontic combined lesion is established. The treatment of periodontal-endodontic combined lesions includes root canal therapy and periodontal regenerative procedure for resolution of both the apical and marginal inflammatory lesions. The present study reports the treatment of periodontal-endodontic combined lesions in the mandibular anterior area with root canal therapy, followed by guided tissue regeneration therapy. Teeth with severe bone destruction in each case could be preserved, without extraction, over a 3-year period. Therefore, it appears that treatment of periodontal-endodontic combined lesions in the mandibular anterior area using guided tissue regeneration technique after root canal therapy may provide clinical advantages.

Keyword

guided tissue regeneration; periodontitis; root canal therapy

MeSH Terms

Dental Pulp Cavity*
Guided Tissue Regeneration*
Periodontitis
Root Canal Therapy*
Tooth

Figure

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  Fig. 1 Clinical photograph of Case A: (A) Initial photograph, (B) After removal of granulation tissue during guided tissue regeneration therapy (six months after root canal therapy), (C) After adaptation of xenograft bone graft material and resorbable membrane, (D) Follow-up after 6 months, (E) Follow-up after 1 year, (F) Follow-up after 3 years.

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  Fig. 2 Periapical radiography of Case A: (A) Initial radiography (six months after root canal therapy), (B) Six months after guided tissue regeneration therapy, (C) Three years after guided tissue regeneration therapy

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  Fig. 3 Clinical photograph of Case B: (A) Initial photograph showing fistula and swelling at mandibular right central incisor (immediately after root canal therapy), (B) After removal of granulation tissue during guided tissue regeneration therapy (three months after root canal therapy), (C) After adaptation of xenograft bone graft material and resorbable membrane, followed by suturing, (D) Follow-up after 6 months, (E) Follow-up after 1 year, (F) Follow-up after 3 years.

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  Fig. 4 Periapical radiography of Case B: (A) Initial radiography, (B) Immediately after root canal therapy, (C) Three months after root canal therapy, (D) Six months after guided tissue regeneration therapy, (E) One year after guided tissue regeneration therapy, (F) Three years after guided tissue regeneration therapy

Reference

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