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Diagnosis and treatment of teeth with primary endodontic lesions mimicking periodontal disease: three cases with long-term follow ups

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초록

A tooth with primary endodontic disease that demonstrates a periodontal defectmight be extracted because of misdiagnosis as severe periodontal disease or a verticalroot fracture. The aim of this case report was to demonstrate the long-term survivalof endodontically treated teeth, which had been initially considered unsavable. Withmeticulous evaluation including the patient’s dental history, clinical and radiographicexaminations, teeth with primary endodontic lesions could be differentiated andsaved after proper root canal treatment. Pain history, vitality test, and radiographicexaminations, as well as a general periodontal condition check with periodontalprobing on an affected tooth, might be the key methods to differentiate endodonticpathosis from that of periodontal disease.

Abstract

A tooth with primary endodontic disease that demonstrates a periodontal defectmight be extracted because of misdiagnosis as severe periodontal disease or a verticalroot fracture. The aim of this case report was to demonstrate the long-term survivalof endodontically treated teeth, which had been initially considered unsavable. Withmeticulous evaluation including the patient’s dental history, clinical and radiographicexaminations, teeth with primary endodontic lesions could be differentiated andsaved after proper root canal treatment. Pain history, vitality test, and radiographicexaminations, as well as a general periodontal condition check with periodontalprobing on an affected tooth, might be the key methods to differentiate endodonticpathosis from that of periodontal disease.

참고문헌 (13)

  1. Simon JH, "The relationship of endodontic–periodontic lesions", J Endod, 39, pp.e41~e46 (2013)
  2. Harrington GW., "The perio-endo question: differential diagnosis", Dent Clin North Am, 23, pp.673~690 (1979)
  3. Chen SY, "The influence of endodontic treatment upon periodontal wound healing", J Clin Periodontol, 24, pp.449~456 (1997)
  4. Bergenholtz G., "Interactions between pulpal and periodontal disease conditions: introduction", Endod Topics, 13, pp.1~2 (2006)
  5. Rotstein I, "The endo-perio lesion: a critical appraisal of the disease condition", Endod Topics, 13, pp.34~56 (2006)
  6. Jansson LE, "The influence of endodontic infection on periodontal status in mandibular molars", J Periodontol, 69, pp.1392~1396 (1998)
  7. Guldener PH., "The relationship between periodontal and pulpal disease", Int Endod J, 18, pp.41~54 (1985)
  8. Harrington GW, "The periodontal–endodontic controversy", Periodontol 2000, 30, pp.123~130 (2002)
  9. Sigurdsson A., "Pulpal diagnosis", Endod Topics, 5, pp.12~25 (2003)
  10. Tamse A., "Vertical root fractures in endodontically treated teeth: diagnostic signs and clinical management", Endod Topics, 13, pp.84~94 (2006)
  11. Pitts DL, "Diagnosis and treatment of vertical root fractures", J Endod, 9, pp.338~346 (1983)
  12. Keesee SM, "A technique for achieving prerestorative minor tooth movement with orthodontic separators", J Prosthet Dent, 88, pp.544~547 (2002)
  13. 신한얼, "교정용 고무 링의 삽입과 임시 전장관의 수정을 통한 보철 수복 전 인접면 공간 획득 – 증례 보고", Restorative Dentistry and Endodontics, 37(2), pp.114~118 (2012), 대한치과보존학회

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