ASystematic review of Effectiveness of Combined Perio — Endo Interventions

Abstract

Objective: The objective of this study is to evaluate longitudinal studies effectiveness of treatment of periodontal-endodontic lesions and the influence of periodontal or endodontic procedures through a systematic review. Methodology: We used bibliographic cataloging electronically identified from MEDLINE, from 1966 until June 26, 2011 and the Cochrane Library, in the same period. As the search strategy used the terms – endodontic periodontal, periodontal or endodontic lesion, endodontic or periodontal lesions, periodontal or endodontic lesion or lesions, endo-perio or endo-perio lesion, periodontal lesion or lesions, endodontics or periodontal lesions -as search keywords. The studies were selected by two reviewers, independently who also determined the criteria for inclusion and exclusion. The search revealed 271 related articles, and of these, 59 articles were literature reviews, 31 articles were related to prospective studies, 76 studies were clinical case reports, 19 studies were conducted in animals and 25 retrospective studies. Results:It was observed that there was a lack of longitudinal studies that met the inclusion criteria, to perform an evidence-based analysis. However, the literature pointed out that successful treatment of lesions of endodontic-periodontic origin is related to the identification of the etiology, control of microbiota present, the immunological characteristics of the individual, and one of the strategies and the possible prognosis is linked to the origin of the process infection (endodontic or periodontal). Conclusion:Within the limitations of the study methodology we conclude that there were no longitudinal studies that met the inclusion criteria with a view for evidence-based analysis. Considering the clinical success of endodonticperiodontal lesions, it is suggested that a control of initial microbial load of oral cavity, followed by control of the endodontic microbiota, then by the periodontal, and finally the performance of