Step‐wise treatment of two periodontal‐endodontic lesions in a heavy smoker

Aim To report a clinical case of two advanced periodontal‐endodontic lesions with a focus on treatment issues related to tobacco use. Summary A 53‐year‐old Caucasian male was referred to the School of Dentistry, Basel, Switzerland, for periodontal treatment. The major diagnoses were chronic (smoker) periodontitis and advanced combined periodontal‐endodontic lesions on the mandibular left lateral incisor and right incisor. Conventional root canal treatment was performed, and subsequently led to reduced radiolucencies around the affected roots after 14 months. The remaining osseous defect was augmented by guided tissue regeneration using bovine bone substitute and resorbable membrane. The follow‐up revealed a stable situation from clinical (probing depth 2–4 mm) and radiological points of view 32 months after initiation of treatment. Treatment considerations related to tobacco use are discussed. Key learning points ? After conventional root canal treatment, osseous healing should occur before further complementary therapy is taken into account. ? Issues related to tobacco use have to be considered before treatment is initiated.