title: A new approach to the treatment of true-combined endodontic-periodontic lesions by the guided tissue regeneration technique.
abstract: Clinicians often have difficulty in the diagnosis and treatment of the combined endodontal and periodontal (endo-perio) lesion. A case of an endo-perio true-combined lesion on a maxillary premolar was first treated with conventional endodontic therapy. Periodontal surgery was then completed, which included scaling and root planing and apical curettage on the tooth. The facial bony defect was then filled with a decalcified freeze-dried bone allograft mixed with tetracycline powder. A non-resorbable Teflon membrane was then used to cover the bone material and the periodontal flap sutured over this. This combined treatment resulted in minimal probing depth (2 mm), maximal clinical attachment gain (8 mm), as well as radiographic evidence of alveolar bone gain. This case report demonstrates that proper diagnosis, followed by removal of etiological factors and utilizing the guided tissue regeneration technique combined with osseous grafting, will restore health and function to a tooth with severe attachment loss caused by an endo-perio lesion.
authors.affiliation: Dental Department, National Cheng Kung University Medical Center, Taiwan Republic of China.
authors.forename: C C
authors.initials: CC
authors.lastname: Tseng
authors.forename: W M
authors.initials: WM
authors.lastname: Harn
authors.forename: Y H
authors.initials: YH
authors.lastname: Chen
authors.forename: C C
authors.initials: CC
authors.lastname: Huang
authors.forename: K
authors.initials: K
authors.lastname: Yuan
authors.forename: P H
authors.initials: PH
authors.lastname: Huang
mesh_terms: D000328:Adult; D016301:Alveolar Bone Loss / Q000209:etiology* / Q000601:surgery*; D001641:Bicuspid; D018775:Bone Demineralization Technique; D016025:Bone Transplantation / Q000379:methods*; D003131:Combined Modality Therapy; D003788:Dental Pulp Diseases / Q000150:complications* / Q000601:surgery*; D016557:Guided Tissue Regeneration, Periodontal / Q000379:methods*; D006801:Humans; D008297:Male; D008437:Maxilla; D017622:Periodontal Attachment Loss / Q000209:etiology / Q000601:surgery; D010510:Periodontal Diseases / Q000150:complications / Q000601:surgery; D010514:Periodontal Pocket / Q000209:etiology / Q000601:surgery; D019233:Retreatment; D012390:Root Canal Therapy; D013524:Surgical Flaps