Treatment of endodontic-periodontic lesions using a root resection approach associated with regenerative materials

Abstract Contextual clues are used to reach the proper diagnosis of a primary periodontal lesion secondary to endodontic involvement, which is an absence of any cause of endodontic infection, such as caries or deep restoration. Therefore, treatment should involve a sequential approach of periodontal and endodontic treatment to address disease entities. A 45-year-old diabetic patient was complaining of maxillary left first molar area, showed a negative response to cold testing, and was not sensitive to percussion or palpation. The tooth has no caries or previous restorations. Deep palatal and interproximal pockets, Grade II furcation involvement, and Grade I mobility were identified. After performing root canal therapy, the palatal root was resected, and retrograde filling was performed with bioceramic putty, followed by freeze-dried bone allograft mixed with recombinant human platelet-derived growth factor-BB (rhPDGF BB) to graft the socket. Follow-up assessments were scheduled for 2 weeks, 3 months, 6 months, and 1 year, revealed significant healing in periodontal health. The patient experienced significant pain relief, along with improved tooth stability and the infection resolving. Root resection combined with rhPDGF-BB and bone grafting has proven to be an effective treatment modality for managing endodontic-periodontal lesions. However, further clinical research is necessary to validate the long-term efficacy and broader applicability of this technique.