Critérios para tomada de decisão para dentes com comprometimento endodôntico e/ou periodontal. Quando indicar a exodontia?

Abstract

INTRODUCTION: The pulp and periodontal tissues are closely related by means of communication between the pulp and the periodontium, endodontic and / or periodontal involvement can cause loss of integrity of the dental element. Basic periodontal treatment aims to remove bacterial biofilm, which is an etiological factor in periodontal diseases, however, in cases of greater complexity and aggressiveness of the disease, conservative treatment becomes complex and questionable. Endodontic treatment, on the other hand, consists of controlling and treating pulp changes and periradicular lesions, which can be emergent, persistent or recurrent. Of the causes of extraction of endodontically treated teeth, post-treatment periradicular injuries, fractures and non-restorable teeth are the main causes. OBJECTIVE: To understand, through a literature review, about the criteria for decision making between the indication of extraction or conservative treatment for teeth with endodontic and / or periodontal involvement. METHODOLOGY: The present study is an exploratory and descriptive study carried out through a literature review. RESULTS: On average, the tooth has a success rate of 99.5% when treated periodontal. The treatment of endodontic lesions through retreatment, microsurgery and periradicular surgery has high success rates. The tooth with a true combined endo-periodontal lesion has a success rate of 27 to 37%. CONCLUSION: When deciding whether to extract or maintain a tooth with periodontal and / or endodontic involvement, there are great success rates, although there is still unpredictability in the prognosis in cases offurcation lesion grade III and vertical root fracture.