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MANAGEMENT OF PERIODONTAL-ENDODONTIC LESION BY REGENERATIVE APPROACH
IN A YOUNG PATIENT WITH AGGRESSIVE PERIODONTITIS: A CASE REPORT

Cheng ZH, Norhayati A

Introduction: Combined periodontal-endodontic lesion has always been a clinical dilemma
and challenge because clinicians often have difficulties in the diagnosis and treatment of
the disease along with deciding a prognosis for the tooth involved. Objective: To illustrate
a significant clinical case and a suggested evidence-based treatment protocol for
periodontal-endodontic lesions, which allows for maintaining teeth that may be considered
hopeless. Case report: We report a case of combined periodontal-endodontic lesion on a
left mandibular first molar in 19-year-old woman with aggressive periodontitis. A
concerted approach was carried out including oral prophylaxis session, conventional
endodontic therapy, nonsurgical periodontal therapy with systemic antibiotics (as an
adjunct), and finally, periodontal regenerative therapy was performed by using guided
tissue regeneration (GTR) technique combined with natural bovine bone graft to allow
regeneration of lost periodontal structures on the mesial aspect. In spite of the anticipated
poor prognosis, the tooth lesion healed. This combined treatment resulted in minimum
probing depth of 3mm, clinical attachment gain of 9mm, as well as radiographic evidence
of alveolar bone gain. Conclusion: This case report demonstrated that proper diagnosis,
followed by a comprehensive treatment protocol that integrates both endodontic and
periodontic specialties and utilizing the guided tissue regeneration technique combined
with osseous grafting will help to restore the health and function of a tooth with severe
attachment loss caused by a periodontal-endodontic lesion. Further research is needed to
evaluate the suggested treatment approach or alternative options for the disease.

Poster presentation at the Malaysian International Dental Exhibition and Conference (MIDEC) 2019.

Dr Cheng Zi Hui
Periodontic Speacialist Unit
Bandar Jerantut Dental Clinic
Pahang

Dr Norhayati bt Abas
Periodontic Speacialist Unit
Paya Besar Dental Clinic
Kuantan Pahang

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