Multidisciplinary management of an endo-perio lesion with internal and external root resorption: A case report

Endo-perio lesions present a diagnostic and therapeutic challenge due to the complex interrelationship between pulpal and periodontal tissues. This case report describes the multidisciplinary management of an endo-perio lesion associated with internal and external root resorption and a fenestration defect in a mandibular first molar. A 27-year-old male presented with pain and swelling in relation to tooth 46. Clinical and radiographic examination, supplemented by cone-beam computed tomography, revealed combined endodontic and periodontal involvement with root resorption and extensive bone loss. Following endodontic therapy, surgical periodontal intervention was performed. The resorptive defect was managed using Biodentine, and the osseous defect was treated with an alloplastic bone graft and platelet-rich fibrin membrane. At 6-month follow-up, the tooth was asymptomatic with satisfactory clinical and radiographic healing. Timely diagnosis and a multidisciplinary treatment approach can result in favorable outcomes in complex endo-perio lesions, preserving the natural dentition.