Retrospective evaluation of the prevalence of endodontic-periodontal lesions on panoramic images in the latest classification of periodontal and peri-implant diseases

Abstract

Aims: This study aimed to determine the prevalence of endodontic-periodontal lesions (EPLs) and EPL grades 1–3 without root damage in patients with and without periodontitis according to the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases. Methods: This study included 500 panoramic radiographs from the Faculty of Dentistry at the University of İstanbul Medipol. Each radiograph was evaluated by a calibrated investigator for diagnostic signs. Patients’ age, sex, total number of teeth, total number of implants, number of filled teeth, number of missing teeth, number of caries, presence of fixed prosthesis, full mouth periodontal diagnosis and determination of the region with the highest radiographic bone loss without EPL were recorded in all patients. For patients with EPL, the presence of EPL and its grading according to the 2017 World Workshop on Classification of Periodontal and Peri-Implant Diseases, the presence of furcation involvement, degree of furcation involvement, the presence of caries in the related tooth, and restoration in the relevant tooth material were also evaluated. Results: The mean age was higher for patients with EPL teeth than without EPL teeth (p<0.05). The mean number of teeth was higher for patients without EPL teeth than patients with EPL teeth (p<0.05). Patients with stage 1 or 2 bone loss mostly had EPL teeth, while patients with stage 3 or 4 mostly did not have EPL teeth (p<0.05). Patients with full mouth stage 1 or 2 diagnoses mostly had teeth with EPL. Patients with grade A or B bone loss mostly had teeth with EPL. Maxillary incisors, mandibular premolars, and mandibular incisors mostly had a “j” profile. Conclusion: The presence of EPL is affected by age, number of teeth, and different periodontal conditions. EPLs were most frequently observed in molars. These results are unsurprising due to the difficulty in brushing the molar areas and periodontal treatment in this area. Because of the complexity of concurrent endodontic and periodontic treatments, the clinical treatment procedure is difficult, the sequence of procedures must be rigorous, and the selection of appropriate materials is critical for optimal and successful treatment in these EPL cases.

Keywords

• Endo-perio lesions
• panoramic radiographs
• periodontal disease
• j-shape
• cone shape

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