Since 1964, when Simring and Goldberg first described the relationship
between periodontal and endodontic disease, the term endo-perio has
become an integral part of the dental vocabulary. An in-depth
understanding of the mechanisms by which these two disease processes
interact, together with a thorough diagnostic examination, usually will
help direct the proper course of treatment. While the deleterious
effects of pulpal disease on the periodontium are well documented, the
converse effect of periodontal disease on the pulp remains unclear.
However, the character of the clinical symptoms may occasionally be
confusing and cause the misinterpretation of their etiology. What
appears to be a periodontal lesion may actually be symptoms of an
endodontic disorder and vice versa. The establishment of a correct
diagnosis may also be complicated when both a periodontal and an
endodontic lesion affect the same tooth simultaneously and may present
as a single lesion. This condition has been termed "true endodontic-
periodontal lesion"