Single-Visit Endodontic Management of a Complex Endo-Periodontal Lesion in an Oncologic Patient with Systemic Comorbidities: A 12-Month Case Report.

Abstract

Background: The endodontic management of patients with complex systemic conditions represents a significant clinical challenge, particularly in cases involving combined endodontic-periodontal lesions and extensive root resorptions. This case report, accompanied by a recent and targeted literature analysis, describes the single-session treatment of an oncologic patient with multiple systemic comorbidities, presenting with a communicating periapical and endodontic-periodontal lesion (EPL), as well as external cervical root resorption (ECR). Methods: Root canal treatment (RCT), combined with ECR repair, was performed using bioceramic materials, via thorough management and planning with cone-beam computed tomography (CBCT) and the aid of an operating microscope. Results: At the 12-month follow-up, complete clinical and radiographic healing was observed, including regeneration of the periodontal ligament and full functional recovery of the tooth. Conclusions: Contrary to what has been reported in the literature, where several studies highlight lower healing rates in patients with systemic comorbidities undergoing endodontic treatment, the present case report demonstrates a favorable and stable outcome. Moreover, the possibility of concentrating the intervention into a single session represents an additional advantage for this category of patients, who often face limited physical and temporal resources due to their concurrent oncologic condition.