Management of Endodontic-Periodontal Defects Using a Combined Approach of Root Canal Therapy and Guided Bone Regeneration

Background: An accurate diagnosis in the endodontic, periapical and periodontal areas is essential for clinical success, especially when endoperiodontal lesions are present. These lesions, which involve both pulp and periodontal tissues, can have similar clinical presentations, making their correct identification difficult without a thorough diagnostic evaluation. A comprehensive diagnosis allows differentiation between whether the pathology has a primary endodontic or periodontal origin or a combination of both, which is essential for selecting the appropriate treatment. Combined assessment through pulp testing, periodontal probing, radiographic analysis and clinical evaluation reduces the risk of inappropriate treatment and significantly improves the prognosis. Ignoring any of these aspects can lead to therapeutic errors, unnecessary loss of tooth structure or even tooth extraction. Therefore, in this clinical case, we will show how root canal treatment, biomaterial-guided tissue regeneration and good soft tissue management are key to treatment success. Case Report: A 55-year-old female patient presented with the complaint of “I have had a crownless tooth for some time.” Following clinical symptoms and Computed Tomography (CT) studies, a diagnosis of a type II endoperiodontal lesion was reached. Root canal treatment was performed, followed by guided tissue regeneration surgery with the placement of a xenograft and resorbable membrane. Conclusion: The Cone-Beam Computed Tomography (CBCT) study showed increased bone density, demonstrating good clinical and CT results after root canal treatment and periodontal regeneration, establishing a good pulp, periapical and periodontal diagnosis is essential for achieving excellent tissue regeneration results.