This case report illustrated the conservative management of an invaginated type II tooth with a large periapical lesion. This dental malformation is characterized by the complexity of root canal anatomy, which when associated with a periapical lesion complicates the performance of conventional endodontic treatment, hence resulting to the difficulty of obtaining the optimal disinfection of the root canal system, which is an essential element for the success of any endodontic treatment. In the present case report, clinical and radiographic examinations were supplemented by CBCT examination to identify the root canal configuration and the extension of the periapical lesion. Conservative orthograde endodontic treatment was performed by combining mechanical and chemical action. Additionally, active nonsurgical decompression was performed and the follow-up visits revealed a favorable outcome.

Objective. The presence of intrapulpal calcifications is one of the effects reported as a consequence of periodontal pathology. Although the impact of the pulp pathology on the periodontium is obvious, the contrary remains unclear and controversial. This study was conducted in order to better understand this fact and establish a potential association between periodontitis and intrapulpal calcifications and then to determine the factors associated with their occurrence. Materials and Methods. To investigate the issue, a retrospective radiological study using periapical preoperative radiographics assessed 332 teeth taken from the records of 79 patients who received treatment for periodontitis. In the second part of the study, 81 of the sample with intact dental crowns presenting an attachment loss were compared to their contralateral with intact dental crowns without any attachment loss. The study of the association between periodontitis and intrapulpal calcifications and the factors associated with their occurrence was performed by the Chi squared and Fisher’s exact tests. The significance level was set at 0.05. Results. The results indicated that 251 (75.6%) teeth had an attachment loss while 102 (30.7%) had intrapulpal calcification. Among the 206 (62%) teeth with intact crown, only 6 (1.8%) showed calcification in the pulp cavity and 20 (6%) showed calcification in the root canals, with a statistically significant difference ( p < 0.005 ) compared to teeth with restorations and caries. For the 32 (19.7%) teeth with coronary calcification, 18 (22.2%) presented an attachment loss versus 14 (17.2%) without attachment loss; the difference was not statistically significant ( p = 0.6 ). Similarly, only 13 (16%) of a total of 22 (13.5%) teeth with root canal calcification had attachment loss versus 9 (11.1%) without attachment loss. This difference was not statistically significant ( p = 0.5 ). Conclusion. This radiographic study revealed no association between the presence of periodontitis and the occurrence of intrapulpal calcifications. Although intrapulpal calcifications were present in some teeth with loss of attachment, they were not necessarily the consequence of periodontal disease.