ETIOPATHOGENIC MOLECULAR MECHANISMS IN THE DEVELOPMENT OF ENDO-PERIODONTAL LESIONS

Abstract

Understanding the interaction between endodontic and periodontal lesions is of crucial importance to the clinician because of the challenges commonly encountered in the evaluation, diagnosis, treatment and prognosis of these combined diseases. Etiological factors (such as microorganisms) as well as factors contributing to the onset and development of endo-periodontal lesions (such as trauma, root resorption, perforations, fractures and dental malformations) play a role in the development and progression of such diseases. The treatment and prognosis of endo-periodontal lesions varies according to the etiology, pathogenesis and the correct recognition of each specific disease. Various molecular mechanisms underlie the onset and development of endo-periodontal lesions as a result of the host’s response to molecular aggression; the inflammatory response involves the recruitment and activation of leukocytes, both non-specific and specific immune responses, with resulting osteoclastogenesis and the formation of an osteolytic lesion at the root apex. Knowing the interdependence between endodontic and periodontal diseases will enhance the clinician’s ability to establish the correct diagnosis, assess the prognosis of the teeth involved, and select a treatment plan based on biological and clinical evidence.