Lesion Sterilization Tissue Repair as Adjunct to Conventional Root Canal Treatment of Combined Periodontic-Endodontic Cases
Ahmed A Saleh, Hossam A Eid, Khalid M Abdelaziz
Citation Information :
Saleh AA, Eid HA, Abdelaziz KM. Lesion Sterilization Tissue Repair as Adjunct to Conventional Root Canal Treatment of Combined Periodontic-Endodontic Cases. World J Dent 2014; 5 (1):47-52.
Treatment of perio-endo lesions is challenging for the clinician. A combination of root canal treatment and periodontal treatment is needed in order to provide good results. There is a high failure rate due to the difficulty in eliminating the microflora that colonizes and complicates the lesion. Conventional root canal treatment (RCT) sometimes is not enough to prevent failure in such lesions. Hence the Aim of this study was to evaluate of use of LSTR (Lesion Sterilization Tisssue Repair) therapy in conjunction with, periodontal therapy and RCT in management of combined perio-endo lesions.
Materials and methods
This study was conducted on 26 patients with perio-endo lesions, The affected teeth were tender to percussion, presented no mobility, and meticulous periodontal probing revealed all pockets to be more than 6 mm in depth. Periapical radiographs of the teeth confirmed the extensive coronal carious lesion involving the pulp and revealed large periapical lesion. The patients were classified into two groups, each of 14 patients, control group (A) RCT done by using conventional sealer, and group (B), RCT done by mixing sealer with LSTR material in equal proportions. All teeth were treated by open flap debridement.
Results
In group B patients, after follow-up for 3, 6, 9 and 12 months, we found excellent prognosis (98%), with no symptoms of pain and there was marked improvement in periodontal parameters for all teeth. However, on the other hand, in group A patients, the prognosis was found to be 90%.
Conclusion
According to results of this study, we highly recommend the use of LSTR with sealer in RCT together with periodontal treatment in management of perio-endo lesions to decrease the rate of failure and improve the periodontal condition.
How to cite this article
Saleh AA, Eid HA, Abdelaziz KM. Lesion Sterilization Tissue Repair as Adjunct to Conventional Root Canal Treatment of Combined Periodontic-Endodontic Cases. World J Dent 2014;5(1):47-52.
The pulpal pocket approach: Retrograde periodontitis. J Periodontol 1964;35:22-48.
Photodiagnosis and Photodynamic Therapy. Sep-Dec 2009;6(3-4):170-188.
The role of calculus in the etiology of periodontal disease. In: Clickmans Clinical Periodontology, 7th ed. Philadelphia: WB Saunders, pp. (1990); 394-395.
Aetiology of root canal treatment failure: why well-treated teeth can fail. International Endodontic Journal 2000;34:1-10.
Factors associated with endodontic treatment failures. Journal of Endodontics 1992;18: 625-627.
3Mix Lesion Sterilization and Tissue Repair Therapy (LSTR) in Extensive Caries of Deciduous Teeth. The Journal of the Philippine Dental Association 2004;56(1):4-13.
Oral histology-development, structure and function. 4 th ed. Mosby; 1994.
The endo-perio problem in dental practice: Diagnosis and prognosis. JADA 1990;56:1005-1011.
Endodontic-periodontic lesions. Part 1; prevalence, aetiology and diagnosis. New Zealand Dent J 1988;84:74-77.
The endodonticperiodontal lesion: a rational approach to treatment. J Am Dent Assoc 1995;126:473-479.
Aust Endodontic J 1998 August;24(2):60-65.
Endodontic treatment of primary teeth using a combination of antibacterial drugs. International Endodontic Journal 2004;37:132-139.
Pathologic interactions in pulpal and periodontal tissues Columbia University, School of Dental and Oral Surgery, Division of Endodontics, New York, NY 10032, USA. Clin Periodontology 2002 August 29;(8): 663-671.
Periapical bacterial plaque in teeth refractory to endodontic treatment. Endodontics and Dental Traumatology 1990;6:73-77.
Periapical actinomycosis: a follow-up study of 16 surgically treated cases. Endodontics and Dental Traumatology 1986;2:205-209.
Survival of Arachnia propionica in periapical tissue. International Endodontic Journal 1988;21:277-282.
Pathogenicity of Actinomyces israelii and Arachnia propionica: experimental infection in guinea pigs and phagocytosis and intracellular killing by human polymorphonuclear leukocytes in vitro. Oral Microbiology and Immunology 1992;7:129-136.
Morphometric analysis of chronic inflammatory periapical lesions in root-filled teeth. Oral Surgery Oral Medicine Oral Pathology 1983;55: 295-301.
Endo-perio lesions: diagnosis and clinical considerations. Indian J Dent Res [serial online] 2010 [cited 2011 Apr 10];21:579-585.
Diagnosis, prognosis and decision-making in the treatment of combined periodontal-endodontic lesions. Periodontol 2000, 2004;34:165-203.
Conventional and surgical retreatment of complex periradicular lesions with periodontal involvement. J Endod 2009 Sep;35(9):1310–1315. Epub 2009 Jul.
Regeneration of periodontal tissues: combinations of barrier membranes and grafting materials—biological foundation and preclinical evidence: a systematic review. J Clin Periodontol 2008 Sep;35(8 Suppl):106-116.
