Abstract / Summary
Endodontic-periodontal lesions are a group of lesions involving both the pulp and periodontal tissues due to the close anatomical and vascular inter-relationship between them. These lesions can present a diagnostic challenge because of their similar clinical manifestations and complex pathogenesis. Early diagnosis and prompt multidisciplinary management are particularly important in adolescents to preserve the natural dentition, to maintain supporting periodontal structures, and ensure proper oral function and aesthetics. This case report describes the successful management of a combined endo-perio lesion in a 13-year-old adolescent patient using a multidisciplinary approach involving endodontic therapy, periodontal therapy, Advanced Platelet-Rich Fibrin (A-PRF), and bone grafting. The patient presented with pain, swelling, deep periodontal pocketing, and radiographic evidence of extensive periapical and periodontal bone loss associated with a permanent mandibular molar. After thorough clinical and radiographic evaluation, a combined endodontic-periodontal lesion was diagnosed. Conventional root canal treatment was initially performed to eliminate the pulpal infection, followed by periodontal surgical intervention. Regenerative therapy was carried out using A-PRF combined with a bone graft to promote healing and regeneration of the lost periodontal structures. Postoperative follow-up demonstrated satisfactory clinical and radiographic healing, reduction in probing depth, improved periodontal attachment, and significant bone fill. This case highlights the importance of accurate diagnosis, interdisciplinary treatment planning, and the regenerative potential of A-PRF and bone grafts in managing endo-perio lesions in young patients, thereby improving prognosis and preserving the natural tooth.