2017 Volume 60 Issue 1 Pages 40-48
Purpose: Diagnosis and treatment plan are important to preserve teeth. However, it is difficult to diagnose correctly from symptoms and findings. In this report, we present two cases of periodontal-endodontic lesions in which endodontic treatment was effective to preserve teeth that had formed deep pockets and that had severely resorbed bone.
Case 1: A 54-year-old woman who complained about repeat gingival swelling in the left molar region. Probing pocket depth (PD) of over 7 mm was found in the left second premolar. Radiographic examination showed that marginal bone resorption was more severe than in the periapical region. The pulp condition could not be examined because of a fixed metal bridge in the left second premolar. However, because the pulp was not vital when a small hole was drilled through the crown and into the dentin, root canal treatment was performed. At 3 weeks after the treatment began, the reduction of PD and improvement of bone around the tooth were observed.
Case 2: A 33-year-old woman who complained about swelling and bleeding in the right molar region. PD of over 7 mm was widely observed. Radiographic examination showed severe bone resorption around the distal root and furcation region, however, furcation involvement was not detected by furcation probe. Although the canal filling did not seem to be bad, periapical bone loss was observed. We considered that the endodontic problem had induced the bone loss although the canal filling did not seem to be bad, therefore, canal treatment was performed. Bone resorption in the periapical region and furcation area improved after the treatment. Scaling, root planing and flap operation led to improvement of the bone condition in the distal area of the distal root.
Conclusion: The condition of bone destruction was so severe that tooth extraction or hemisection of distal root was considered. However, bone resorption was improved and teeth could be preserved by endodontic treatment.
