Since 1964, when Simring and Goldberg first described the relationship between periodontal and endodontic disease, the term endo-perio has become an integral part of the dental vocabulary. An in-depth understanding of the mechanisms by which these two disease processes interact, together with a thorough diagnostic examination, usually will help direct the proper course of treatment. While the deleterious effects of pulpal disease on the periodontium are well documented, the converse effect of periodontal disease on the pulp remains unclear. However, the character of the clinical symptoms may occasionally be confusing and cause the misinterpretation of their etiology. What appears to be a periodontal lesion may actually be symptoms of an endodontic disorder and vice versa. The establishment of a correct diagnosis may also be complicated when both a periodontal and an endodontic lesion affect the same tooth simultaneously and may present as a single lesion. This condition has been termed "true endodontic- periodontal lesion"
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