Oral Health Group

The vision behind the Clinical eChronicle – Endo Perio

May 15, 2011
by ken

From the ROOTS forum

This forum is dedicated to an understanding of FOUNDATIONAL DENTISTRY and the Endodontic Implant Algorithm.  Ask yourself the obvious question before you view the treatment images…….are you “implant driven in your treatment planning perspective?”  Would you have removed this tooth (teeth) and grafted the extraction site?  If so, you’ve just validated the concept behind the Clinical eChronicle.  Companies sell product and equipment that have specific applications. But in the absence of sound biologic and physiologic fundamental understanding, the tools that need to be used may well be used incorrectly.

patient was referred for consultation and treatment of #25 and #26. They
presented with pain in the upper right quadrant and swelling in the area of the
#25 and #26. The referring dentist had prepared both teeth for PFMs and they
were provisionalized. Percussion of both teeth was very painful, mobility
(2-3+). There was a deep pocket (approximately 11-12mm) between molar and
premolar. Vitality testing was positive for molar and negative for
premolar.  Preoperative X-rays showed
periradicular bone resorption and pocket depth, checked by guttapercha point.

debridement and disinfection procedures were completed, calcium hydroxide
dressing was placed for 4 weeks and it’s filling quality checked by x-ray.

4 weeks there were no signs of pain or 
swelling. 26 still has positive reaction for cold test. Normal mobility
of molar, premolar has 1-2 grade of mobility. During final obturation a small
lateral canal was filled, perhaps this one caused periradicular bone
destruction and join two microbiotas – endo and perio one.  Elimination of the endodontic infection led
to partial healing but for my view periodontal treatment is needed for the
further repair.






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Best regards, Ilya Mer






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