Study of Arising Mechanism and Therapy for Endodontal Periodontal Lesion

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We give an outline of this study. 1.Analysis of the clinical state on endodontal periodontal lesion: We collected specimens and classified them according to case histories, clinical findings and radiographical findings. Then we compared the histopathological state of the dental pulp with the clinical state. And the relationships between the proteinases such as elastase, cathepsins B, H and L in gingival crevicular fluid and clinical states were examined. 2.The study on the combination of periodontal and endodontal lesions: 1 We examined the frequency of accessory canals using the methods of Replica, SEM and image analysis. 2 We studied the diagnosing method by measuring the electric resistance value between root canal and periodontal tissue. 3 We examined the spreading pathway of inflammation from the pursuit of the derection of tissue fluid flow. As a result, endodontic lesion easily spread periodontal tissue, but only periodontal lesion with severe periodontal breakdown spread the pulp and the maxillary sinus. 3.The study on bacterial flora: Microbial density was low in root canals, but it was high in periodontal pockets. Cultivable bacterial flora was simpler than that in root canals. IgG antibody titers to some specific bacterias were high, but the kind of bacteria was different case by case. Then we examined the relationship between the treatment and the change of bacterial flor a(especially anaerobe) in root canals and periodontal pockets. As for the total number of bacteria, we could neither detect any bacteria in the canal by just one root canal treatment, nor did we find any change of the number in periodontal pockets just only by the treatments. 4.The study on the treatment: We histopathologically observed the periodontal wound healing in the case of animal tooth reimplantation. Blood coagulation factor FXIII was effetive on the wound healing.