(34) Clinical and microbiological analysis of endodontic-periodontal lesions treatment

Introduction: Endodontic-periodontal (EP) lesions are inflammatory processes involving periodontal and dental pulp tissues, with microorganisms as the main etiological factor. The present study hypothesizes that the successful treatment of EP lesions is correlated with reducing the main pathogens related to periodontal disease. Therefore, our objective was to evaluate the effect of EP treatment on clinical and microbiological parameters at 1 month post-treatment

Methods: Ten teeth with EP lesions underwent endodontic and periodontal nonsurgical treatment, in which microbiological sample collections from the periodontal pocket were performed at baseline and 1-month post-treatment. Root canal sample collections were performed at baseline and on the day of canal obturation. The real-time PCR assay assessed counts of Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola, and total bacterial load. The periodontal and endodontic clinical evaluations were performed at baseline and 1-month post-treatment.

Results: It was observed that endodontic and periodontal treatment resulted in a 1.40 ± 0.96 reduction in Probing Depth (PD) at one-month post-treatment (p < 0.001). In addition, treatment of teeth with EP lesions resulted in an attachment gain of 1.10 ± 0.99 after 1 month (p = 0.006). Only T. denticola showed a tendency (p = 0.06) to decrease after one month of post-treatment. At baseline, it was possible to observe a positive and significant correlation between the total microbial load and the clinical parameters: PD, clinical attachment level (CAL), tooth mobility, and lesion size in x-ray (p < 0.05). The red complex was positively correlated with tooth mobility, lesion size on x-ray, and pain on palpation (p < 0.05). Treatment failure was positively correlated with the final count of P. gingivalis (p < 0.05).

Conclusions: The greater complexity of the microbiota of EP lesions may represent a more significant challenge in reducing the microbial load. Furthermore, the persistence of high counts of P. gingivalis can result in treatment failure, worsening the prognosis of the tooth with EP lesion.

Lead Author's Contributions to the Research Project. : the lead author was responsible for the conception of the study, data collection and analysis and composition of the abstract