Marginal periodontitis

Sometimes a diagnosis between marginal and apical periodontitis is difficult. A deep pocket reaching the tooth apex can have its origin either in the root canal or a marginal periodontal infection. If the pulp is necrotic, it is very important to start the endodontic treatment and then wait up to several weeks to observe the periodontal reaction before considering periodontal therapy. If the cause of the pocket is primarily endodontic, unnecessary periodontal treatment will cause irreversible damage to the tooth supporting tissues.