Prognostic Factors of Grade 2-3 Endo-Periodontal Lesions Treated Nonsurgically in Patients with Periodontitis: A Retrospective Case-Control Study

Abstract

Background. Endo-periodontal lesions are bacterial infectious diseases involving both the periodontal and pulp tissues with poor outcomes. It is hard for clinicians to predict their prognosis. The aim of this study is to investigate the factors affecting the prognosis of endo-periodontal lesions. Methods. A total of 140 teeth diagnosed with grade 2-3 endo-periodontal lesions in patients with periodontitis were recruited in this study. They were divided into high and low responder groups, according to the clinical symptoms and parameters of the teeth involved after nonsurgical treatment of both the endodontic and periodontal components. Clinical parameters and symptoms were compared before and after treatment, and gender, age, smoking, and all clinical parameters were compared between high and low responder groups using univariate analyses. Logistic regression was applied to evaluate the independent effects on endo-periodontal lesion prognosis. Results. Compared with the clinical parameters at baseline, the values of tooth mobility (TM), periapical index (PAI), and discomfort when chewing were decreased after endodontic therapy, and the values of periodontal probing depth (PD), clinical attachment level (CAL), sulcus bleeding index (SBI), TM, simplified oral hygiene index (OHI-S), full-mouth periodontitis severity, PAI, and discomfort when chewing were decreased after periodontal therapy. Univariate analysis revealed that smoking, PD, CAL, TM, PAI, clinical crown-root ratio (CR), full-mouth periodontitis severities, and the number of root canals were significantly different between the high and low responder groups (P<0.05). The logistic regression analysis showed that smoking, PD, CAL, full-mouth periodontitis severities, and the number of root canals remained significantly associated with grade 2-3 endo-periodontal lesions in patients with periodontitis (P<0.05). Conclusionsand Practical Implications. High PD and CAL, multirooted teeth, smoking, and serious full-mouth periodontitis indicated a poor prognosis for teeth with grade 2-3 endo-periodontal lesions.

Next-Generation Sequencing Analysis of Root Canal Microbiota Associated with a Severe Endodontic-Periodontal Lesion

“…Endo-periodontal lesions (EPLs) are bacterial infectious diseases that together affect periodontal and endodontic tissues of the same tooth, with periodontal tissue damage and pulp inflammation/necrosis, defined by a pathological communication between the pulpal and periodontal tissues [5].…”

“…The most common signs and symptoms associated with a tooth affected by EPLs are deep periodontal pockets reaching or close to the apex with a periodontal probing depth (PD) of ≥5 mm and a clinical attachment level (CAL) of ≥3 mm, and a negative or altered response to pulp vitality tests, including spontaneous pain history [5,9].…”

The impact of covid-19 on a patient with a severely compromised permanent maxillary central incisor.

“…In the combined lesions a periodontal treatment is also important to influence the secondary periodontal disease, because of the communication between the endodontic and periodontal processes, the use of therapeutic drugs is essential to kill any bacteria and to stimulate tissue repair. [17][18][19][20][21][22].…”

Clinical, radiographic characterizations and complications of maxillary molar in a non-agomphiasis periodontitis population: a retrospective study based on CBCT three-dimensional reconstruction

“…Accumulating evidence has revealed that periodontitis could induce various complications, including periodontal abscess, pulp lesions, furcation lesion, as well as mucosal thickening [16][17][18]. First of all, the special anatomical structures, including the apical foramen, the lateral and accessory canals, and the dentinal tubules, form an intimate continuum between the periodontal and endodontic tissues, through which pathological changes of either may lead to infection of the other [30,31]. These ndings indicate the communication between the periodontal and endodontic tissues and pulp lesions could be induced by periodontitis.…”