Revitalizing pulpo perio complex

Endodontic–periodontal combined lesions pose a treatment challenge for clinicians, especially when the lesion is persistent and does not show signs of healing after nonsurgical endodontics. This case report describes interdisciplinary management of a nonhealing combined lesion related to a periapical cyst through an integrated approach of apicoectomy and regenerative periodontics. A 51-year-old male patient presented with a sinus tract for 4 months after endodontic retreatment of the maxillary right central and lateral incisor. Surgical enucleation of the cystic lesion together with regenerative periodontics using bone graft, advanced platelet-rich fibrin plus membrane, and guided tissue regeneration membrane to treat the tunnel bony defect was done. Clinical and radiographic examination at 6 months showed resolution of lesion, reduction in probing depths, and good bone fill of the defect.