CSAR 40 - Perio-endo lesions

Question 1

What is marginal periodontitis? and how does it present?

Answer 1

Biofilm growing down the outer aspect of the tooth (calculus and plaque)
Widespread among teeth 
Deep probing/bleeding/calculus 
Suppuration through periodontal pockets
Possible swelling coronal to MGJ

Question 2

Why does bone destruction occur in periodontitis?

Answer 2

Biofilms produce by-products which cause bone destruction

Question 3

How is a sinus tract/swelling apically to the MGJ treated and how long does it take to resolve?

Answer 3

Endo treatment, closing in 2-7 days

Question 4

How is a sinus tract/swelling presenting as a pocket managed?

Answer 4

RCT

OHI, but no RSI

Question 5

After marginal periodontitis managed, what response of the tissues occurs?

Answer 5

Pockets close with long junctional epithelium

Little or no bony/PDL regeneration

Question 6

What is the difference between perio-endo lesions 1.with and 2.without communication?

Answer 6

1. Looks like black band around lower half of tooth - marginal bone loss reaches apical bone loss
2. When probing, don’t have deep narrow pocket, not to apex

Question 7

How is a perio-endo lesion treat WITHOUT communication?

Answer 7

Treat both apical and marginal periodontitis concurrently and aggressively

Question 8

How is a perio-endo lesion treat WITH communication?

Answer 8

Endo first - any tissue lost due to endo disease will heal
Aggressive OHI and calculus removal
RSI usually 1 month after endo as some bony infill will have occured