Page 58 - The Beauty and Sorrow in Endodontics-Chapter 3

Conclusion

Dental caries (resulting in pulpal degeneration) and periodontal disease are the two

most infectious oral diseases. Having either one can severely impact a person’s daily life.

Having both problems further complicates treatment options and results. In this chapter,
the author presented cases of infections that are of either endodontic or periodontal

origins, or both. An operator must first diagnose the problem to be able to provide
appropriate treatment for the patient. If the mobility and apical pathology of a tooth

originated solely from its surrounding periodontium with no impact on pulpal tissue,
there is no need for endodontic treatment. Likewise, if the problem arises from the

periodontium and has later infected the pulpal tissue, even if endodontic treatment had

been completed, if the underlying periodontal problem is not addressed, then complete
healing cannot be expected. Furthermore, once both endodontic and periodontal

treatments are completed properly, the determining factor to the overall prognosis

becomes whethera traumatic occlusion is present. As long as the underlying problems are
addressed one by one, even extremely mobile teeth with large apical pathology will

return to a healthy state.

Dr. Schilder’s Remark:

The attachment apparatus (cementum, periodontal fibers, and bone) is the vital organ
of the tooth, not the pulp. Everything anatomically is against the vitality of the pulp.

In endodontics, we are really talking about the health of the attachment apparatus.

When the patient asks for your expertise on whether to retain the tooth via endodontic

treatment or replace it with an implant, how does one analyze the pros and cons of each

option for the patient? Continue to the next chapter to find out!

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