endo-perio connection

lecture given 6/8/2026

lateral canals

while migrating apically and forming the root the epithelial sheath of hertwig can have discontinuities or run across blood vessels

these disruptions can lead to the formation of lateral canals

more frequent in furcation area and apical 1/3

detinal tubules

number and size- decrease from pulp to cementum, decrease from cervical to apical

dentinal fluid

tissue pressure in the pulp is approx 14cm H2O

exposed dentine- outward movement of dentinal fluid 0.02 nl/sec/mm2

protective? transport media?

brannstrom’s hydrodynamic theory

the rapid movement of dentinal fluid in the dentinal tubules stimulates a delta nerve fibers located in the odontoblastic layer of the pulp

mechano-stimulation

dentin infection

death of the odontoblast, dead tract, bacterial infiltration

pulpal response to carious lesion

pulpal inflammation

local tissue destruction

formation of microabscesses- attempt to wall off infection

apical foramina

most significant pathway of communication between pulp and periodontium

microorganisms- P to PDL, deep apical pocket to PDL

what clinical exam should be done?

endodontic

periodontal- PD, bleeding on probing, purulence, mobility, density of marginal bone

SOAP

subjective, objective, assessment (pulpal and periradicular diagnosis), plan of treatment (endo, perio. prosth)

what should go in the S of soap?

chief complaint, history of present condition, clinical exam, radiographic examination, diagnostic tests (tracing sinus tract)