Résumé
La existencia de una íntima conexión entre el conducto radicular y el ligamento periodontal, ha dado lugar a lo que se conoce como relaciones endoperiodontales. Esto se debe a la presencia de varias vías anatómicas de comunicación entre ambas entidades: el foramen apical, los forámenes laterales pertenecientes a conductos accesorios y conductillos dentinarios en zonas de ausencia del cemento dentario protector. Los microorganismos y sus agentes tóxicos tienen la capacidad de afectar ambos tejidos en esa interrelación física y biológica. El diagnóstico diferencial entre enfermedad endodóntica y periodontal es de vital importancia para la elección del tratamiento y el pronóstico a distancia.
The intimate connection between the root canal and theperiodontal ligament generates a concept that is known asendo-periodontal relationships. This is due to the presence ofseveral anatomical communications between them: apical foramen,lateral foramina and dentinal tubules denuded of theircementum coverage. Microorganisms and their toxic agentscan affect both tissues due to this physical and biological interrelation.Proper differential between endodontic and periodontaletiology is vital to the accurate choice of treatment andfor the long term prognosis.
Sujets)
Humains , Cavité pulpaire de la dent/anatomie et histologie , Maladies de la pulpe dentaire/physiopathologie , Maladies parodontales/physiopathologie , Desmodonte/anatomie et histologie , Diagnostic différentiel , Fistule dentaire/complications , Fistule dentaire/diagnostic , Cavité pulpaire de la dent/microbiologie , Nécrose pulpaire/microbiologie , Maladies parodontales/microbiologie , Poche parodontale/microbiologie , Reprise du traitement/méthodes , Traitement de canal radiculaire/méthodesRésumé
Palatal radicular grooves are developmental anomalies of maxillary incisors, which contribute to localized periodontitis resulting in loss of anterior teeth. Palatal radicular grooves, when present, act as a site for plaque accumulation and periodontal infection. They are easily overlooked as etiologic factors, as these grooves are covered by periodontal tissues. The clinician has to be alert and check for variations in the anatomy of the tooth as a cause of pulp necrosis in the anterior segment of the tooth, when other causes are ruled out. Recognition of palatal radicular grooves is critical, especially because of its diagnostic complexity and the problems that may arise if it is not properly interpreted and treated. This case report describes the diagnosis and management of a maxillary lateral incisor with necrotic pulp and localized periodontal destruction, associated with a palatal radicular groove.