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Tropical Dental Journal - 1st Pan African international dental journal


Tropical Dental Journal



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Published in English in Tropical Dental Journal Volume 47 - March 2024 pages 13-20

Madame Sabra Jaâfoura Understanding endo-periodontal lesions for a better treatment: case reportUnderstanding endo-periodontal lesions for a better treatment: case report est évalué 1 étoiles par les abonnés Tropical Dental Journal Online

Article Open access

Authors : A. Kikly, S. Jaâfoura, A. Bouslama, E. Garouachi, N. Douki - Tunisia


Résumé

Les lésions endo-parodontales impliquent deux entités biologiques distinctes, l’espace endodontique et les tissus parodontaux, qui sont intimement liés, définissant un véritable "continum endo-parodontal". De nombreuses voies de communication permettent aux processus infectieux et/ou inflammatoires de se propager d’un compartiment à l’autre. Outre les voies anatomiques évidentes, il en existe d’autres que l’on peut qualifier de pathologiques ou iatrogènes. Ces lésions représentent un défi pour le praticien en termes de diagnostic et de pronostic. En effet, le pronostic des lésions endo-parodontales est inférieur à celui de toute pathologie individuelle. Le contrôle des infections endodontiques est essentiel et facile à réaliser : il s’agit de garantir l’herméticité du système canalaire. L’aspect parodontal est en revanche le plus complexe à contrôler, puisqu’il s’agit de contrôler l’infection en milieu ouvert, d’où l’importance de la phase d’entretien parodontal. La collaboration interdisciplinaire est donc essentielle pour obtenir des résultats optimaux.
Dans cet article, nous présentons les critères cliniques et radiologiques nécessaires pour une approche sûre et pragmatique du traitement de ces lésions.

Abstract
Understanding endo-periodontal lesions for a better treatment: case report

Endo-periodontal lesions involve two distinct biological entities, the endodontic space and the periodontal tissues, which are intimately linked, defining a veritable "endo-periodontal continuum".
Numerous communication routes allow infectious and/or inflammatory processes to spread from one compartment to the other. In addition to the obvious anatomical pathways, there are others that can be described as pathological or iatrogenic. These lesions represent a challenge for the practitioner in terms of diagnosis and prognosis. Indeed, the prognosis of endo-periodontal lesions is inferior to that of any individual pathology. Endodontic infection control is essential and easy to achieve: it is to ensure the hermeticity of the root canal system. The periodontal aspect, on the other hand, is the most complex to control, since it involves controlling infection in an open environment, hence the importance of the periodontal maintenance phase. Interdisciplinary collaboration is therefore essential to achieve optimum results.
In this article, we present the necessary clinical and radiological criteria for a safe and pragmatic approach to the treatment of these lesions.

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