Effect of endodontic treatment on periodontal healing of grade 3 endo-periodontal lesions without root damage in periodontally compromised patients—a retrospective pilot study

Abstract

Objectives There is little evidence about the effect of different treatment protocols for grade 3 endo-periodontal lesions without root damage in patients with periodontitis according to the new classification of periodontal disease. The aim of this study is to evaluate the impact of endodontic treatment on the achievement of periodontal healing. Materials and methods Teeth with the initial diagnosis endo-periodontal lesion without root damage grade 3, treated with a standardized endodontic treatment protocol, were included in this study. A retrospective analysis was performed to assess the impact on periodontal healing by evaluating probing pocket depth (PPD), clinical attachment gain (CAL), and periapical index score (PAI). Results Nineteen teeth and 13 patients were included. A mean reduction of 3.19 ± 3.41 mm in PPD was recorded. The mean CAL gain was 2.33± 3.75 mm. Five teeth (45.4%) showed an improvement of PAI and were classified as treatment success. Conclusions The results failed to show a highly predictable treatment outcome for endo-periodontal lesion grade 3 without root damage in patients with periodontitis. However, endodontic therapy alone resulted in treatment success for some of the teeth, which would otherwise have had a poor prognosis. Clinical relevance Endo-periodontal lesions can often be challenging for dentists in daily clinical practice. To date, there is not much evidence for practitioners to rely on. Therefore, this study aims to strengthen the evidence for the management and treatment of endo-periodontal lesions. Although the outcome is not highly predictable yet, teeth with the initial diagnosis endo-periodontal lesion without root damage grade 3 can benefit from an endodontic treatment.

Endoperiodontal lesions: diagnosis first, then treatment and not always tooth extraction: a cross-sectional survey in Spain and a proposal of a clinical treatment protocol

“…According to these, 289 EPL were treated with a follow-up between 6 ( 11 , 17 ) and 216 ( 14 ) months. Single therapy with endodontic treatment got a mean CAG of 2.33 mm ( 15 , 16 ). Combination protocols proposed for EPL therapy included the endodontic treatment alongside: 1) non-surgical periodontal therapy (NSPT) (CAG= 4.57 mm) ( 2 , 11 ) NSPT and periodontal surgical therapy (CAG= 5.22 mm) ( 3 , 17 , 18 ) Guided tissue regeneration (GTR) (CAG= 6.75 mm) ( 10 , 12 , 13 , 23 ), and 4) NSPT and plastic periodontal surgery (CAG=10 mm) ( 10 , 14 ).…”

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

“…Success rates tend to be lower after endodontic retreatment than after initial treatment, suggesting that biofilm infection may continue and affect the healing of EPLs, although endodontic retreatment is often effective even in patients with advanced EPLs [ 57 ] ( Figure 5 ). Endodontic and periodontal education and practical training of dental students, including specialists, may improve the treatment outcomes.…”

Management of Teeth with Grade 3 Endo-Periodontal Lesions by Combined Endodontic and Regenerative Periodontal Therapy

“…There is a common consensus in the recent literature that root canal treatment in teeth affected by endo-periodontal lesions should be performed first [ 8 , 9 , 10 ]. However, sole endodontic treatment has failed to prove as a highly predictable therapy for teeth affected by endo-periodontal lesions [ 10 ].…”