The more severe form of the dental infection is the endo-perio lesion. The characteristics of this type of lesion is that radiograph will show a radiolucent band around the entire roots of a tooth.
This type of dental infection is a more aggressive form of dental infection. It usually happens when there is an untreated infection and the affected area has spread to the entire roots of the tooth. One common cause of such infection is from vertical fracture of the tooth. The bacteria has traveled from the oral cavity to infect the root and bone around the tooth. Thus, if there is an endo-perio lesions evident in radiograph, it has the possibility that the tooth might have some kind of fracture.
This type of dental infection is very aggressive that a typical dental treatment of root canal therapy might not be enough to cure it. Even after root canal therapy and rigorous antibiotic regimen, the prognosis of the tooth is guarded, which means it could be less favorable compared to tooth with a more minor form of infections. However, root canal therapy is the last defense of saving the tooth before a tooth is deemed unsalvable from the infection.
If there is a through-and-through vertical fracture, the tooth cannot be restored and it needs to be taken out. Vertical fracture essentially split the tooth in half and no dental fillings or crowns can hold the tooth together. No dental fillings or crowns can repair the cracks below the roots of the tooth and bacteria can get through those cracks.
Option to restore the unsalvable tooth is to first extract the tooth and then restore it with implants.
Written by Daniel Tee, DDS, MS
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