Combined periodontic endodontic lesions are localized circumscribed areas of bacterial infection originating from either dental pulp periodontal tissues surrounding . Endodontic and periodontal lesions can manifest identical symptoms despite originating from separate pathogens and traditional classification has . An acute exacerbation of a chronic apical lesion on a tooth with a necrotic pulp may drain coronally through the periodontal ligament into the gingival . In periodontal lesions the prognosis of a true combined perio endo lesion is often poor or even hopeless especially when periodontal lesions are
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