From Volume 46, Issue 8, September 2019 | Pages 738-740
Periodontal-endodontic (perio-endo) lesions involve pulpal and periodontal disease in the same tooth and are seen routinely by dental practitioners. An unusual presentation of a perio-endo lesion in the lower left mandible is demonstrated. It caused significant buccal expansion and perforation of the lingual plate, and was provisionally diagnosed as a malignancy.
Periodontal-endodontic (perio-endo) lesions involve the association of pulpal and periodontal disease within the same tooth. These lesions can cause a diagnostic dilemma for clinicians and it is important for the correct diagnosis to be made to ensure appropriate treatment is carried out. Aetiological factors include bacteria, viruses and fungi. Other factors, including trauma, root resorption, perforations and dental malformations, can play a role in the progression of perio-endo lesions.1
Malignancy of the oral cavity can present as ulceration or a raised lesion with or without induration, non-healing sockets, loose teeth, swelling, pain/numbness and lymphadenopathy, amongst many other symptoms.
The case of an unusual predicted malignancy, confirmed as a perio-endo lesion associated with lower left first and second molars, is demonstrated. The case highlights the need for practitioners to be aware of atypical appearances of such lesions.
A 77-year-old man was referred to the oral surgery department regarding an unusual peri-radicular lesion associated with the lower left first and second molars. There was no pain associated with the lower left quadrant but he was aware of a swelling in this region with altered sensation. On clinical examination, the lower left first molar was grade I mobile and the lower left second molar was grade II mobile. Buccal and lingual expansion was noted on palpation.
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