{"id":20750,"date":"2022-02-21T08:50:45","date_gmt":"2022-02-21T14:50:45","guid":{"rendered":"https:\/\/www.aae.org\/specialty\/?p=20750"},"modified":"2022-02-25T11:35:04","modified_gmt":"2022-02-25T17:35:04","slug":"5-questions-to-ask-when-determining-if-teeth-with-perio-endo-infections-can-be-saved","status":"publish","type":"post","link":"https:\/\/www.aae.org\/specialty\/5-questions-to-ask-when-determining-if-teeth-with-perio-endo-infections-can-be-saved\/","title":{"rendered":"5 Questions to Ask When Determining if Teeth With Perio-Endo Infections Can be Saved"},"content":{"rendered":"<p><em>By Scott Froum, D.D.S.,\u00a0 and Marcus Johnson, D.D.S., M.S.D.<\/em><\/p>\n<p><em>This article was originally published in <\/em>Perio-Implant Advisory <em>on May 8, 2017. It was updated for clinical accuracy on February 15, 2022.<\/em><\/p>\n<p>Many clinicians struggle with the question of whether a tooth experiencing an infection from an endodontic, periodontic, or combination lesion is worth trying to save. These teeth may require root canal, periodontal, and restorative therapy. Is it worth it to try to treat and save the tooth versus taking it out and placing a dental implant or bridge? This article will guide you through this decision by explaining how to diagnose the infection and suggest questions you should ask when deciding upon the method of treatment.<\/p>\n<p><strong><img loading=\"lazy\" decoding=\"async\" class=\"alignright size-aae-medium-rectangle wp-image-20751\" src=\"https:\/\/www.aae.org\/specialty\/wp-content\/uploads\/sites\/2\/2022\/02\/figure1-295x190.jpg\" alt=\"\" width=\"295\" height=\"190\" \/>1. What is the etiology of the infection?<\/strong><br \/>\na. Treatment is dictated by etiology; furthermore, so is prognosis<\/p>\n<p><strong>2. What is the clinical\/radiographic presentation?<\/strong><br \/>\na. How mobile are the teeth: Class I, II, or III?<\/p>\n<p>b. How severe is the probing: less than 5 mm, 5\u20138 mm, or greater than 8 mm<\/p>\n<p>c. Is the furcation involved if multirooted teeth? If so, is it Class I, Class II, or Class III?<\/p>\n<p>d. Is the bone loss vertical or horizontal, and what is the severity?<\/p>\n<p>e. Is there a sinus tract and\/or edema present?<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignright wp-image-20753 \" src=\"https:\/\/www.aae.org\/specialty\/wp-content\/uploads\/sites\/2\/2022\/02\/table1.jpg\" alt=\"\" width=\"393\" height=\"191\" srcset=\"https:\/\/www.aae.org\/specialty\/wp-content\/uploads\/sites\/2\/2022\/02\/table1-300x146@2x.jpg 600w, https:\/\/www.aae.org\/specialty\/wp-content\/uploads\/sites\/2\/2022\/02\/table1-300x146.jpg 300w, https:\/\/www.aae.org\/specialty\/wp-content\/uploads\/sites\/2\/2022\/02\/table1-150x73.jpg 150w\" sizes=\"auto, (max-width: 393px) 100vw, 393px\" \/><\/p>\n<p><strong>3. Restorability: Can the tooth be restored with a restoration that will last?<\/strong><br \/>\na. Can coronal and radicular dentin be preserved after caries removal?<\/p>\n<p>b. Can contamination of the root canal system be avoided?<\/p>\n<p>c. Can a proper post and core be placed without causing root fracture?<\/p>\n<p>d. Is adequate ferrule present?<\/p>\n<p>e. Is adequate interocclusal space present to allow for crown placement?<\/p>\n<p>f. Is crown lengthening needed, and if so, how much reduction is necessary?<\/p>\n<p><strong>4. What are the costs and compliance involved?<\/strong><br \/>\na. Can the patient afford treatment by multiple specialists?<\/p>\n<p>b. What are the anticipated maintenance fees?<\/p>\n<p>c. Is the patient motivated, and will the patient comply with long-term follow-up?<\/p>\n<p><strong>5. What are the alternative treatment options to present to the patient?<\/strong><br \/>\na. Hemisection\/bicuspidization of multirooted teeth<\/p>\n<p>b. Root amputation<\/p>\n<p>c. Guided tissue regeneration<\/p>\n<p>d. Extraction and subsequent implant therapy<\/p>\n","protected":false},"excerpt":{"rendered":"<p>By Scott Froum, D.D.S.,\u00a0 and Marcus Johnson, D.D.S., M.S.D. This article was originally published in Perio-Implant Advisory on May 8, 2017. It was updated for clinical accuracy on February 15,&hellip;<\/p>\n","protected":false},"author":12,"featured_media":20751,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"content-type":"","_relevanssi_hide_post":"","_relevanssi_hide_content":"","_relevanssi_pin_for_all":"","_relevanssi_pin_keywords":"","_relevanssi_unpin_keywords":"","_relevanssi_related_keywords":"","_relevanssi_related_include_ids":"","_relevanssi_related_exclude_ids":"","_relevanssi_related_no_append":"","_relevanssi_related_not_related":"","_relevanssi_related_posts":"","_relevanssi_noindex_reason":"","footnotes":""},"categories":[266],"tags":[],"feature":[236],"class_list":["post-20750","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-uncategorized","feature-paperpoint"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.1.1 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>5 Questions to Ask When Determining if Teeth With Perio-Endo Infections Can be Saved - American Association of Endodontists<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.aae.org\/specialty\/5-questions-to-ask-when-determining-if-teeth-with-perio-endo-infections-can-be-saved\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"5 Questions to Ask When Determining if Teeth With Perio-Endo Infections Can be Saved - American Association of Endodontists\" \/>\n<meta property=\"og:description\" content=\"By Scott Froum, D.D.S.,\u00a0 and Marcus Johnson, D.D.S., M.S.D. 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