How to deal with endo-perio syndrome?

Treating the endo-periodontal leasions is always quite problematic. Many publications opine this kind of pathology as one of the most difficult. In 2006 Jorge Vera, Martin Trope, Federic Barnett and Kenneth S Serota indicated that endo-perio syndrome can be successfully healed by very srcupulous root canal treatment with puting special emphasis on canal desinfection. Sometimes the inflammation at the periapex may gives radiographically the same symptoms as periodontal disease. Accessory and collateral root canals may very often serve as a potential pathway for the spread of bacterial toxines or infected pulp which can trigger an inflammatory vascular response in the periodontal tissues. This all makes the diagnosis so difficult. The main factors to consider are thepulp vitality and type and extent of the periodontal defect. It all confirms the cause which was the beginning of the leasion. Until we have the right diagnosis the suitable treatment can not be delivered. We wish that presented film will be felpfull for you all!