An endodontic abscess can track through the periodontal ligament. Sometimes the patient complaints about bleeding around the tooth. When there is a deep pocket and it is not a patient with more periodontal problems it could be a sinus track. Often the concerning tooth has a big filling. Also a fracture can be the cause of a nonvital pulp. Sometimes the patient complaints about a dirty tast.
The diagnosis can be confirmed when sensitivity tests are negative.
A recent radiograph (radiolucency) can help with the diagnosis.
When an endodontic problem is the reason of a periodontal pocket, endodontic (re)treatment should be done. The solitair pocket (about the same as a fistula) has to disappear within some weeks.
Also a (vertical)fracturecan cause problems which looks like an endodontic/periodontal problem. The use of an Operating Microscope can help a lot with the diagnosis.
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