DOI:

10.37988/1811-153X_2023_4_18

Treatment, prevention and outcomes of endo-periodontal lesions: a modern view

Authors

  • D.A. Moiseev 1, PhD in Medical Sciences, head of the Simulation technologies in dentistry Lab
    ORCID ID: 0000-0001-7811-7741
  • I.S. Kopetsky 1, PhD in Medical Sciences, professor of the Therapeutic dentistry Department, director of the Institute of Dentistry
    ORCID ID: 0000-0002-4723-6067
  • I.A. Nikolskaya 1, PhD in Medical Sciences, professor of the Therapeutic dentistry Department
    ORCID ID: 0000-0001-8042-2884
  • O.Yu. Guseva 1, PhD in Medical Sciences, associate professor of the Therapeutic dentistry Department
  • E.G. Mikhailova 1, PhD in Medical Sciences, associate professor of the Therapeutic dentistry Department
    ORCID ID: 0000-0003-4985-9441
  • D.A. Eremin 1, PhD in Medical Sciences, assistant professor and head of the Maxillofacial dentistry Department
    ORCID ID: 0000-0003-4077-6359
  • N.N. Patrakova 1, PhD in Medical Sciences, associate professor of the Therapeutic dentistry Department
    ORCID ID: 0009-0005-2019-4636
  • I.V. Pogabalo 1, PhD in Medical Sciences, full professor of the Therapeutic dentistry Department
    ORCID ID: 0000-0002-3106-6710
  • A.A. Ogloblin 1, senior laboratory technician at the Therapeutic dentistry Department
    ORCID ID: 0009-0001-4662-6338
  • 1 Pirogov Russian National Research Medical University, 119571, Moscow, Russia

Abstract

Endo-periodontal lesions (EPL) are clinical conditions involving both the tooth pulp and periodontal tissues in the pathological process. There is insufficient data on the effectiveness of the use of different protocols for the treatment and prevention of EPL, there are no diagnostic algorithms that allow the doctor to correctly diagnose. Prognosis plays a key role in treatment planning. The purpose of the study: to summarize the available data on modern methods of treatment and prevention, prognosis of the course and outcomes of EPL.
Materials and methods.
A systematic review of the literature data was carried out, 1721 publications were found, presented in international electronic databases: PubMed, Google Search, Ebsco, Embase, Web of Science, ScienceDirect, SciELO and eLibrary from 2000 to 2023. Based on the selection criteria, 54 publications were selected, which included the results of studying the diagnosis, treatment and prevention, prediction and outcomes of EPL. The methodology of this study meets the requirements for systematic reviews and meta-analyses of «PRISMA».
Results.
Traditional protocols are described, as well as modern approaches to the treatment and prevention of EPL. Special attention is paid to the prediction of the development and outcomes of EPL; prognostic criteria and factors that worsen the outcome of EPL treatment are highlighted.
Conclusion.
The presented detailed systematic analysis showed that the problems of treatment and prevention, prediction and outcomes of EPL are insufficiently studied and represent a difficult task for clinicians. The data obtained during the study can help practicing dentists in determining the prognosis of EPL and the development of comprehensive therapeutic and preventive measures.

Key words:

pulp, periodontal disease, periodontitis, pulpitis, endo-periodontal lesions, treatment, prevention, diagnosis, prognosis

For Citation

[1]
Moiseev D.A., Kopetsky I.S., Nikolskaya I.A., Guseva O.Yu., Mikhailova E.G., Eremin D.A., Patrakova N.N., Pogabalo I.V., Ogloblin A.A. Treatment, prevention and outcomes of endo-periodontal lesions: a modern view. Clinical Dentistry (Russia).  2024; 26 (4): 18—28. DOI: 10.37988/1811-153X_2023_4_18

References

  1. Betancourt P., Elgueta R., Fuentes R. Treatment of endo-periodontal lesion using leukocyte-platelet-rich fibrin. A case report. Colomb Med (Cali). 2017; 48 (4): 204—207. PMID: 29662262
  2. Moiseev D.A., Volkov S.I., Konov A.A., Kulyukina M.A. The morphological and functional relationship between dental pulp and periodontal tissue in the aspect of endo-perio lesions. Parodontologiya. 2021; 4: 289—299 (In Russian). eLIBRARY ID: 47596088
  3. Moiseev D., Rumyantsev V., Volkov S., Kulyukina M., Konov A. Morphological aspects of the relationship between periodontal tissues and dental pulp. Actual Problems in Dentistry. 2021; 2: 77—83 (In Russian). eLIBRARY ID: 46411886
  4. Ruetters M., Kim T.S., Krisam J., El-Sayed S., ElSayed N. Effect of endodontic treatment on periodontal healing of grade 3 endo-periodontal lesions without root damage in periodontally compromised patients-a retrospective pilot study. Clin Oral Investig. 2021; 25 (4): 2373—2380. PMID: 32948927
  5. Pereira R., Arboleda S. A Multidisciplinary approach of an endo-perio lesion in a severely compromised tooth: An 18-year follow-up case report. J Med Life. 2020; 13 (4): 629—634. PMID: 33456615
  6. Galieva D.T., Atrushkevich V.G., Tsarev V.N., Mitronin A.V. The endodontic periodontic affections: actual issues. The Journal of Disease Treatment and Prevention. 2015; 4 (16): 85—91 (In Russian). eLIBRARY ID: 25372177
  7. Bonaccorso A., Tripi T. Endo-perio lesion: diagnosis, prognosis and decision-making. ENDO. 2014; 8 (2): 105—127.
  8. Moiseev D.A. Features of prevention, treatment and prognosis of dental pulp pathology in patients with chronic periodontitis: dissertation. Tver, 2023. 182 p. (in Russian).
  9. Fan X., Xu X., Yu S., Liu P., Chen C., Pan Y., Lin L., Li C. Prognostic factors of grade 2—3 endo-periodontal lesions treated nonsurgically in patients with periodontitis: A retrospective case-control study. Biomed Res Int. 2020; 2020: 1592910. PMID: 32090068
  10. Matthews D.C. Prevention and treatment of periodontal diseases in primary care. Evid Based Dent. 2014; 15 (3): 68—9. PMID: 25343386
  11. Moroz P.V., Iordanishvili A.K. Risk factors of emergence and reason of low efficiency of treatment endodontoparodontalnykh of lesions. Endodontics Today. 2018; 1: 35—41 (In Russian). eLIBRARY ID: 35001913
  12. Tasdemir Z., Oskaybas M.N., Alkan A.B., Cakmak O. The effects of ozone therapy on periodontal therapy: A randomized placebo-controlled clinical trial. Oral Dis. 2019; 25 (4): 1195—1202. PMID: 30739369
  13. Makeeva M.K. The use of ozone-air mixture in the complex treatment of endodonto-periodontal lesions: dissertation abstract. Moscow, 2014. 25 p. (in Russian).
  14. Barbosa F.I., Araújo P.V., Machado L.J.C., Magalhães C.S., Guimarães M.M.M., Moreira A.N. Effect of photodynamic therapy as an adjuvant to non-surgical periodontal therapy: Periodontal and metabolic evaluation in patients with type 2 diabetes mellitus. Photodiagnosis Photodyn Ther. 2018; 22: 245—250. PMID: 29709606
  15. Segarra-Vidal M., Guerra-Ojeda S., Vallés L.S., López-Roldán A., Mauricio M.D., Aldasoro M., Alpiste-Illueca F., Vila J.M. Effects of photodynamic therapy in periodontal treatment: A randomized, controlled clinical trial. J Clin Periodontol. 2017; 44 (9): 915—925. PMID: 28667678
  16. Abduljabbar T., Vohra F., Javed F., Akram Z. Antimicrobial photodynamic therapy adjuvant to non-surgical periodontal therapy in patients with diabetes mellitus: A meta-analysis. Photodiagnosis Photodyn Ther. 2017; 17: 138—146. PMID: 27888163
  17. Dembowska E., Jaroń A., Homik-Rodzińska A., Gabrysz-Trybek E., Bladowska J., Trybek G. Comparison of the treatment efficacy of endo-perio lesions using a standard treatment protocol and extended by using a diode laser (940 nm). J Clin Med. 2022; 11 (3): 811. PMID: 35160262
  18. Pretzl B., Sälzer S., Ehmke B., Schlagenhauf U., Dannewitz B., Dommisch H., Eickholz P., Jockel-Schneider Y. Administration of systemic antibiotics during non-surgical periodontal therapy-a consensus report. Clin Oral Investig. 2019; 23 (7): 3073—3085. PMID: 30374830
  19. Mombelli A. Microbial colonization of the periodontal pocket and its significance for periodontal therapy. Periodontol 2000. 2018; 76 (1): 85—96. PMID: 29193304
  20. Keestra J.A., Grosjean I., Coucke W., Quirynen M., Teughels W. Non-surgical periodontal therapy with systemic antibiotics in patients with untreated chronic periodontitis: a systematic review and meta-analysis. J Periodontal Res. 2015; 50 (3): 294—314. PMID: 25142259
  21. O'Rourke V.J. Azithromycin as an adjunct to non-surgical periodontal therapy: a systematic review. Aust Dent J. 2017; 62 (1): 14—22. PMID: 27492140
  22. Serino G., Rosling B., Ramberg P., Socransky S.S., Lindhe J. Initial outcome and long-term effect of surgical and non-surgical treatment of advanced periodontal disease. J Clin Periodontol. 2001; 28 (10): 910—6. PMID: 11686808
  23. Shaddox L.M., Walker C.B. Treating chronic periodontitis: current status, challenges, and future directions. Clin Cosmet Investig Dent. 2010; 2: 79—91. PMID: 23662085
  24. Mailoa J., Lin G.H., Khoshkam V., MacEachern M., Chan H.L., Wang H.L. Long-term effect of four surgical periodontal therapies and one non-surgical therapy: A systematic review and meta-analysis. J Periodontol. 2015; 86 (10): 1150—8. PMID: 26110453
  25. Zholdasova N.Zh., Isayeva G.K., Iztleuova G.B., Tkachenko Ye.M. Comprehensive approach to treatment of endoperiodontal lesions. West Kazakhstan Medical Journal. 2015; 4 (48): 29—33 (In Russian). eLIBRARY ID: 25956314
  26. Mitronin A.V., Popova V.M., Dashkova O.P., Galieva D.T., Belozerova N.N. Long-term effects of endodontic treatment et endo-perio disease. Endodontics Today. 2017; 2: 37—40 (In Russian). eLIBRARY ID: 29969382
  27. Sorokina N.V. Endodontic interventions in patients with periodontitis: master's thesis abstract. Smolensk, 2007. 22 p. (In Russian).
  28. Aksel H., Serper A. A case series associated with different kinds of endo-perio lesions. J Clin Exp Dent. 2014; 6 (1): e91—5. PMID: 24596642
  29. Song M., Kang M., Kang D.R., Jung H.I., Kim E. Comparison of the effect of endodontic-periodontal combined lesion on the outcome of endodontic microsurgery with that of isolated endodontic lesion: survival analysis using propensity score analysis. Clin Oral Investig. 2018; 22 (4): 1717—1724. PMID: 29098442
  30. Saha A.P., Chakraborty A., Saha S. Endodontic-periodontal lesion: A two-way traffic. International Journal of Applied Dental Sciences. 2018; 4 (4): 223—228.
  31. Van der Weijden G.A.F., Dekkers G.J., Slot D.E. Success of non-surgical periodontal therapy in adult periodontitis patients: A retrospective analysis. Int J Dent Hyg. 2019; 17 (4): 309—317. PMID: 30942938
  32. Fatemi K., Disfani R., Zare R., Moeintaghavi A., Ali S.A., Boostani H.R. Influence of moderate to severe chronic periodontitis on dental pulp. J Indian Soc Periodontol. 2012; 16 (4): 558—61. PMID: 23493524
  33. Peeran S.W., Thiruneervannan M., Abdalla K.A., Mugrabi M.H. Endo-perio lesions. International journal of scientific & technology research. 2013; 5 (2): 268—274.
  34. Sharma R., Hegde V., Siddharth M., Hegde R., Manchanda G., Agarwal P. Endodontic-periodontal microsurgery for combined endodontic-periodontal lesions: An overview. J Conserv Dent. 2014; 17 (6): 510—6. PMID: 25506135
  35. Lin L.M., Ricucci D., Saoud T.M., Sigurdsson A., Kahler B. Vital pulp therapy of mature permanent teeth with irreversible pulpitis from the perspective of pulp biology. Aust Endod J. 2020; 46 (1): 154—166. PMID: 31865629
  36. Moiseev D.A. Particularities of prevention, treatment and prognosis of dental pulp pathology in patients with chronic periodontitis: master's thesis abstract. Tver, 2022. 22 p).
  37. Moiseev D., Rumyancev V., Volkov S., Rodionova E., Zhuravleva D. Computer modeling of endo-periodontal lesion. The possibilities of using a 3D model in the educational process. Cathedra. Dental education. 2022; 80: 44—47 (In Russian). http://kstom.ru/c8044
  38. Blinova A.V., Rumyantsev V.A. Nanomaterials in the modern dentistry (review). Stomatology. 2021; 2: 103—109 (In Russian). eLIBRARY ID: 45607624
  39. Zablotskaya N.V., Mitereva M.I., Zablotskaya M.V., Mitronin Yu.A. Modern view on physiotherapeutic methods of prevention and treatment hyperesthesia of teeth. Endodontics Today. 2019; 4: 40—42 (In Russian). eLIBRARY ID: 41669680
  40. Kulikova A.A., Nikolaeva A.D., Zablotskaya N.V., Blinova A.V., Rumyantsev V.A., Bityukova E.V. Modern nanomaterials and nanomedications in dentistry: literature review. Upper Volga Medical Journal. 2020; 2: 16—20 (In Russian). eLIBRARY ID: 43791532
  41. Rumyantsev V.A., Fedotova T.A., Zablotskaya M.V., Yusupova Yu.I., Ryabikov M.D., Moiseev D.A. New method of complex treatment of endodont-parodontal diseases by nanoimpregnation and cupral- curettage. Upper Volga Medical Journal . 2017; 4: 4—9 (In Russian). eLIBRARY ID: 32239360
  42. Rumyantsev V.A., Nekrasov A.V., Moiseev D.A., Zadorohniy D.V., Pankin P.I. Biofilm in endodontics. Part II. Methods of struggle against biofilm in endodontic treatment of teeth (review of literature). Endodontics Today. 2018; 2: 38—42 (In Russian). eLIBRARY ID: 35575636
  43. Rumyantsev V.A., Shimansky Sh.L., Gassparyan M.G., Asayan A.G., Rybikov M.D., Moiseyev D.A., Yusupova Y.I. Influence of macrophage reprogramming biotechnologyon the initiated inflammatory reaction in the periodont of mice (pilot study). Medical Newsletter of Vyatka. 2019; 2 (62): 56—60 (In Russian). eLIBRARY ID: 38213969
  44. Rumyantsev V.A., Avakova D.R., Blinova A.V. Host response modulation in periodontology and implantology: potential of anti-inflammatory, antibacterial therapy and promising dosage forms. Review. Parodontologiya. 2019; 4: 372—377 (In Russian). eLIBRARY ID: 41531667
  45. Rumyantsev V.A., Shimansky Sh.L., Budashova E.I., Yusupova Yu.I., Afonenkova V.S., Moiseyev D.A. Modern concept of polarization of macrophages and its importance for periodontology (literature review). Parodontologiya. 2018; 3 (88): 64—69 (In Russian). eLIBRARY ID: 36409047
  46. Oh S., Chung S.H., Han J.Y. Periodontal regenerative therapy in endo-periodontal lesions: a retrospective study over 5 years. J Periodontal Implant Sci. 2019; 49 (2): 90—104. PMID: 31098330
  47. Moiseev D.A., Kopetsky I.S., Nikolskaya I.A., Ilyukhin G.S., Gazarov S.Yu., Madatyan G.K., Sevastyanova V.V., Kurbatina A.B. The problem of primary infection in endo-periodontal lesions: a systematic review. Endodontics Today. 2023; 2: 115—123 (In Russian). eLIBRARY ID: 54647058
  48. Semkin V.A., Nadtochiy A.G., Kuzin A.V., Kolotikov P.A. The effectiveness of tooth-preserving surgery in various forms of inflammatory and destructive lesions in mandibular molars area. Stomatology. 2019; 2: 60—63 (In Russian). eLIBRARY ID: 37785550
  49. Elovikova T.M., Baranova I.A. Predictive aspects of periodontitis: endo-periodontal lesions. Actual Problems in Dentistry. 2012; 5: 4—7 (In Russian). eLIBRARY ID: 18267542
  50. Moroz P.V., Ataeva S.V., Birkina Y.A. Strategy of treatment of patients with endodont-parodontal diseases with application of directional tissue regeneration. Health and Education Millennium. 2017; 8: 27—31 (In Russian). eLIBRARY ID: 29185925
  51. Ruiz X.F., Duran-Sindreu F., Shemesh H., García Font M., Vallés M., Roig Cayón M., Olivieri J.G. Development of periapical lesions in endodontically treated teeth with and without periodontal involvement: A retrospective cohort study. J Endod. 2017; 43 (8): 1246—1249. PMID: 28606666
  52. Newman M., Takei H., Klokkevold P., Carranza F. Newman and Carranza's clinical periodontology. Saunders, 2018. Pp. 88—90.
  53. Grudyanov A.I., Makeeva M.K., Pyatigorskay N.V. Modern Concepts of Etiology, Pathogenesis and Treatment Approaches to Endo-Perio Lesions. Annals of the Russian Academy of Medical Sciences. 2013; 8: 34—36 (In Russian). eLIBRARY ID: 20226330
  54. Sunitha V R., Emmadi P., Namasivayam A., Thyegarajan R., Rajaraman V. The periodontal endodontic continuum: A review. J Conserv Dent. 2008; 11 (2): 54—62. PMID: 20142886

Received

July 13, 2023

Accepted

November 21, 2023

Published on

January 16, 2024