The importance of correct diagnosis and treatment in endo-periodontal lesions: a two cases comparison

This paper illustrates two endo-periodontal lesions treated with the same standardized protocols with different prognoses. In the first case, the endodontics and periodontal therapies were performed with clinical and radiological healing of the lesion. In the second case, the tooth had to be extracted because of repeated inflammatory processes. In order to investigate the reasons for failure, the extracted tooth was submitted to clearing process, followed by stereomicroscope observation. It revealed a vertical fracture running along the palatal root, not detectable by radiographic examination. This pathway between pulpal and periodontal tissues determined the negative prognosis of the treatment. CPD/Clinical Relevance: This report aims to highlight how root vertical fractures may not be readily detectable to the standard bi-dimensional radiograph.