Periodontally derived pulpal lesions

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Abstract
Concurrent pulpal and periodontal disease has been described as the outcome of the pathogenetic interactions between the pulp and the periodontium. Although the existence of primary endodontic lesions with secondary periodontal involvement, as well as that of “true” combined ones has been undoubtedly justified, some controversy and confusion still exist over primary periodontal lesions with secondary endodontic involvement. In this article, theoretical communicable pathways between pulp and periodontal ligament, which can be responsible for the extension of the primary periodontal inflammatory lesion in the pulp, are described. Furthermore, a re‐evaluation of the pulpal invasion phenomenon is presented, based on recent research and clinical findings that demonstrate that no constant relationship between the depth of the periodontal pocket and the status of the pulp has ever been found.

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