Endo-perio lesions: classification, diagnosis, treatment and prognosis

Abstract

Objective: To characterize the classification, diagnosis, treatment, and prognosis of endoperiodontal lesions. Bibliographic review: The concomitant occurrence of periodontal and endodontic changes in the same tooth defines endoperiodontal lesions. Anatomical communication pathways, morphological changes, and root surface destruction allow the endodontium and periodontium to share contamination, inflammatory, and infectious characteristics, giving rise to endoperiodontal lesions. Low prevalence in dental clinics, the suggested classifications help professionals identify and establish more specific approaches that improve prognosis. Diagnosis and treatment are complex for the dentist, requiring knowledge of both periodontics and endodontics. The treatment sequence that favored periodontal attachment gain and endoperiodontal lesion resolution initially included endodontic treatment, followed by periodontal treatment to eliminate contamination. The time interval between treatments varies. Procedures such as root amputation or sealing with specific materials for tooth loss due to cracks, fractures, perforations, or morphological changes eliminate the communication pathway, improving the prognosis. After eliminating the contamination, regenerative procedures may be indicated to improve existing bone defects. Final considerations: Diagnosis and treatment of these lesions require multidisciplinary approach, and their prognosis is influenced by the characteristics of the tooth, the extent of periodontal attachment loss, the possibility of endodontic treatment, and the need for rehabilitation.