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

Yıl 2023, Cilt: 6 Sayı: 4, 737 - 744, 30.07.2023

Hüseyin Gürkan Güneç , Tuğçe Paksoy , Caner Atalay , Kader Aydın

https://doi.org/10.32322/jhsm.1293681

Öz

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.

Anahtar Kelimeler

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

Kaynakça

• Herrera D, Retamal-Valdes B, Alonso B, et al. Acute periodontal lesions (periodontal abscesses and necrotizing periodontal diseases) and endo-periodontal lesions. J Periodontol. 2018;89 Suppl 1:85–102.
• Zehnder M, Gold SI, Hasselgren G. Pathologic interactions in pulpal and peri- odontal tissues. J Clin Periodontol. 2002;29(8):663–71.
• Papapanou PN, Sanz M, Buduneli N, et al. Periodontitis:Consensus report of work group 2 of the. 2017 World Workshop on the classification of periodontal and peri-implant diseases and conditions. J Periodontol. 2018;89 Suppl 1:173–82.
• Chapple IL, Lumley PJ. The periodontal-endodontic interface. Dent Update. 1999;26(8):331-6,338,340-1.
• Cohen J. Statistical power analysis for the behavioral sciences. Hillsdale, New Jersey:Lawrence Erlbaum Associates;1998.
• Walton RE. Vertical root fracture:Factors related to identification. J Am Dent Assoc. 2017;148(2):100–5.
• Ruetters M, Gehrig H, Kronsteiner D, et al. Prevalence of endo-perio lesions according to the. 2017 World Workshop on the classification of periodontal and peri-implant disease in a university hospital. Quintessence Int. 2022;53(2):134-42.
• Altaf A, Jeelani M, Basher A. Assessment of prevalence of Endo-perio lesions among patients of known population:An observational study. Inter J of App Dent Sci. 2019;5(3):111-3.
• Cucolo FCC, Bonvalente MC, Barroso EM, et al. Endo-perio lesions prevalence in non-molar and molar teeth:a pilot study. Rev Odontol UNESP. 2021;50:e20210037.
• Prashaanthi N, Arvina R, Shantha Sundari KK. Prevalence of endo perio lesion- an institutional study. Int J Dentistry Oral Sci. 2021;8(6):2858-62.
• Dako T, Lazăr AP, Mâru MA, et al. Prevalance of Endo-Perio Lesions among Adult Patients, an observational study. Romanian J Med and Dent Edu. 2021;10(3):16-21.
• Robo I, Heta S, Haxhiu E, et al. Evaluation of endo-perio lesions according to different specific classifications. SN Comp Clin Med. 2022. doi:10.21203/rs.3.rs-1849923/v1
• Kim E, Song JS, Jung IY, et al. Prospective clinical study evaluating endodontic microsurgery outcomes for cases with lesions of endodontic origin compared with cases with lesions of combined periodontal-endodontic origin. J Endod. 2008;34(5):546-51.
• Fan X, Xu X, Yu S, et al. Prognostic factors of grade 2-3 endo-periodontal lesions treated nonsurgically in patients with periodontitis:a retrospective case-control study. BioMed Res Inter. 2020;2020:1592910.
• Simon JH, Glick DH, Frank AL. Predictable endodontic and periodontic failures as a result of radicular anomalies. Oral Surg Oral Med Oral Pathol 1971;31(6):823-26.
• Xuelian T, Lan Z, Dingming H. [Intentional replantation for the treatment of palatal radicular groove with endoperiodontallesion in the maxillary lateral incisor:a case report]. Hua Xi Kou Qiang Yi Xue Za Zhi. 2017;35(4):448-52.
• Estrela C, Bueno MR, Azevedo BC, et al. A new periapical index based on cone beam computed tomography. J Endod. 2008;34(11):1325–31.
• Jaro´n A, Gabrysz-Trybek E, Bladowska J, et al. Correlation of panoramic radiography, cone-beam computed tomography, and three-dimensional printing in the assessment of the spatial location of impacted mandibular third molars. J Clin Med. 2021;10(18):4189.