Abstract
Abstract Introduction Pulp and periodontal tissues may communicate and, in pathological situations, combined endodontic-periodontal lesions may be established. Objective The aim of this study was to evaluate the prevalence of endo-perio lesions in non-molar and molar teeth referred for endodontic treatment. Material and method The sample consisted of 104 teeth evaluated in 79 consecutive patients in a cross-sectional design. Visible plaque, probing depth, and bleeding on probing were evaluated. Endodontic evaluation included the presence or absence of caries, fistulas, pain, and pulp sensitivity. The presence/absence of periapical lesion, bone loss in the furcation region, and proximal area were evaluated. Result The results showed that pain was the main reason for seeking dental care in 63.3% of patients. The molar teeth demonstrated higher presence of probing depth (PD) ≥ 7 mm (38.3%) and higher PD mean (6.17 mm) than non-molar teeth (P<0.05). It was verified that 65.4% of the teeth were diagnosed with a primary endodontic lesion and that the periodontal component was present in 34.6% of the teeth, either in a primary (10.6%), secondary (11.5%), or combined form (12.5%). True combined endodontic-periodontal lesion occurred significantly in molar teeth compared to non-molar teeth (p<0.05). Conclusion The primary endodontic lesion was found in a greater proportion in teeth referred for endodontic treatment; however, approximately 1/3 of the sample had periodontal involvement, which demonstrates the importance of the periodontal examination together with the general clinical examination.
Highlights
Pulp and periodontal tissues may communicate and, in pathological situations, combined endodontic-periodontal lesions may be established
The primary endodontic lesion was found in a greater proportion in teeth referred for endodontic treatment; approximately 1/3 of the sample had periodontal involvement, which demonstrates the importance of the periodontal examination together with the general clinical examination
Several other classifications have been proposed to date[2,3,4,5], of which the classification by Simon et al.[2,4] is the most widely used to identify etiologic factors, addressing different clinical conditions that consider the primary cause of the disease, such as the presence of a primary endodontic lesion; primary endodontic lesion with secondary periodontal involvement; primary periodontal lesion; primary periodontal lesion with secondary endodontic involvement; and true combined lesion[5]
Summary
Endodontic-periodontal lesions are included in the category of other conditions that affect the periodontium by the new classification of the American Academy of Periodontology and the European Federation of Periodontology[1]. In the case of isolated endodontic and periodontal lesions, the diagnosis can be established, in most cases, without much difficulty, considering the clinical and radiographic signs, in certain situations in which a tooth is affected by pulp and periodontal disease, concomitantly, the clinical signs are not as clear because the clinical aspects are confused[6]. Regarding endodontic/periodontal primary and secondary involvement and true combined lesions, the radiographic aspects may be confused since they are very similar. There is still a lack of clinical studies regarding the aspects of endodontic-periodontal lesions in molar and non-molar teeth. Given these considerations, the objective of this study was to perform a periodontal evaluation on single-rooted and multiradicular teeth, referred for endodontic treatment, in order to assess the prevalence of periodontitis involvement in these teeth and to verify the relationship of endoperiodontal lesions
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