Comparison of the Treatment Efficacy of Endo−Perio Lesions Using a Standard Treatment Protocol and Extended by Using a Diode Laser (940 nm)

Abstract

Marginal and periapical periodontal diseases cause massive destruction of tooth tissues and surrounding tissues, such as alveolar bone and maxillary sinus floor, visible on radiographs. Lesions involving the apical and marginal periodontium are endo−perio (EPL) lesions. This study aimed to compare the treatment efficacy of endo−perio lesions using a standard treatment protocol and a standard diode laser-assisted treatment protocol. The 12 patients were divided into the study (a) and control (b) group. Periodontal indices, tooth vitality and mobility, occlusal status, and radiographic diagnosis were evaluated. Standard EPL treatment was then performed—without (a) and with (b) the use of diode laser (940 nm). Again, after six months, the above-mentioned parameters were evaluated and compared. The treatment of endo−perio lesions is a significant challenge for modern dentistry. Diode lasers are increasingly used in addition to traditional treatment methods. The conventional use of a 940 nm diode laser with an average power of 0.8 W in pulsed mode allows for the depth of periodontal pockets to be reduced. In addition, the use of a diode laser has a significant effect on tooth mobility and reduces bone loss.

Clinical Efficacy of Treatment of Endodontic-Periodontal Lesions: A Systematic Scoping Review of Experimental Studies

“…The characteristics of the included studies are presented in Table 1 . These studies were published between 2012 [ 6 ] and 2022 [ 7 ]. The investigations assessed 739 teeth in 730 patients, with a minimum sample of 12 patients [ 7 ] and a maximum of 327 patients [ 8 ].…”

“…Multiple therapies were performed, including endodontic and periodontal approaches with non-surgical and surgical methods, in addition to the use of different materials for endodontic and periodontal treatment. Researchers compared the treatment efficacy of EPL using endodontic treatment and scaling and root planing (SRP) performed simultaneously versus SRP performed 3 months after endodontic treatment [ 3 ], a standard treatment protocol and a standard diode laser-assisted treatment [ 6 , 7 ], gutta-percha (GP) and mineral trioxide (MTA) as an obturation material alone and with the addition of bone grafting [ 8 ], root canal treatment plus periodontal treatment versus endodontic treatment plus supragingival scaling [ 9 ], endodontic treatment plus the platelet-rich fibrin (PRF) versus endodontic treatment plus titanium-prepared platelet-rich fibrin (T-PRF) [ 10 ], and open flap debridement (OFD) performed 21 after initiation of endodontic treatment plus SRP versus OFD performed 3 months after initiation of endodontic treatment and SRP [ 10 ] ( Table 1 ). It is important to note that endodontic and periodontal treatments were implemented simultaneously in most trials [ 6 , 7 , 8 , 9 , 10 ].…”

“…Two studies were non-randomized clinical trials [ 1 , 9 ], and five were RCTs [ 3 , 6 , 7 , 8 , 10 ]. All studies had a follow-up period of between 6 and 24 months.…”

“…Because a new classification of EPL has been recently introduced [ 2 ], the diagnoses presented in the included articles are reflected as follows: endo-periodontal lesion in periodontitis patients in three trials [ 7 , 9 , 10 ] and endo-periodontal lesion in non-periodontitis patients in the remaining four experiments [ 1 , 3 , 6 , 8 ].…”

Personalized Medicine Based on the Pathogenesis and Risk Assessment of Endodontic–Periodontal Lesions

“…Additional clinical training is essential for both root canal preparation and periodontal surgery. Ozone and laser treatments of EPLs may show beneficial effects [ 54 , 55 ].…”