Collaborative Management of Combined Periodontal-endodontic Lesions with a Palatogingival Groove: A Case Series

J Endod. 2017 Feb;43(2):332-337. doi: 10.1016/j.joen.2016.10.003. Epub 2016 Dec 15.

Abstract

Introduction: This article reports 3 representative cases of interdisciplinary management of a palatogingival groove in maxillary lateral incisors. The development, pathology, and effectiveness of management approaches in cases involving a combined periodontal-endodontic lesion with a palatogingival groove are discussed.

Methods: We describe 3 patients with a noncontributory medical history presenting with a chief complaint related to a maxillary incisor and diagnosed with a combined periodontal-endodontic lesion with a palatogingival groove at Seoul National University Dental Hospital, Seoul, Korea.

Results: Palatogingival grooves were mostly associated with deep periodontal pockets connected to a periapical lesion. Optional collaborative treatments were performed according to the condition as follows: case 1, root canal treatment (RCT), open flap debridement, odontoplasty, and guided tissue regeneration; case 2, RCT, apicoectomy, open flap debridement, and odontoplasty; and case 3, RCT, crown restoration, root planning, and odontoplasty. After clinical examination and radiographic assessments, the periapical lesion and periodontal deep pocket were successfully resolved with periodontal-endodontic collaborative treatment involving both periodontal surgical procedures (cases 1 and 2) and a nonsurgical procedure (case 3).

Conclusions: Within the limitations of this study, these case reports show that accurate diagnosis of developmental anomalies and elimination of inflammatory irritants are key factors for favorable long-term outcomes.

Keywords: Combined periodontal-endodontic lesion; gingival tissue regeneration; odontoplasty; palatogingival groove.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Dental Pulp Necrosis / complications
  • Dental Pulp Necrosis / pathology
  • Dental Pulp Necrosis / therapy
  • Female
  • Gingiva / pathology
  • Humans
  • Incisor / abnormalities*
  • Incisor / pathology
  • Male
  • Middle Aged
  • Palate / pathology
  • Patient Care Team
  • Periodontal Diseases / complications*
  • Periodontal Diseases / pathology
  • Periodontal Diseases / therapy
  • Radiography, Dental
  • Tooth Diseases / complications*
  • Tooth Diseases / pathology
  • Tooth Diseases / therapy
  • Tooth Root* / diagnostic imaging
  • Tooth Root* / pathology