Basic Studies Department, School of Dentistry, Universidad de Antioquia UdeA, Medellín 050010, Colombia.
School of Dentistry, Institución Universitaria Visión de Las Américas, Medellín 050031, Colombia.
Int J Environ Res Public Health. 2022 Oct 21;19(20):13649. doi: 10.3390/ijerph192013649.
In this review, we evaluated the clinical efficacy of interventions used for the treatment of endo-perio lesions (EPL).
A systematic scoping review of clinical trials was developed.
Seven clinical trials were studied. In at least one study group of six of the seven evaluated trials, endodontic and periodontal treatments were performed simultaneously. All trials showed improvement in probing depth in the studied groups; nevertheless, the experimental groups of five studies demonstrated a statistically significant reduction in this parameter. An increase in clinical attachment level was also reported ( < 0.05). Most trials reported an increase in the filling of the bone defect following therapy ( < 0.05). Mechanical periodontal therapy implemented simultaneously with endodontic therapy demonstrated efficacy in the treatment of concurrent EPL without communication. Endodontic treatment and immediate periodontal surgery did not affect the result of the management of combined EPL with apical communication. The use of diode laser, the management of platelet-rich fibrin (PRF) and titanium-prepared PRF, and the implementation of bone grafts plus endodontic treatment with mineral-trioxide or gutta-percha seems to be an adequate strategy in patients with EPL.
The treatment of EPL using simultaneous endodontic and periodontal therapies seems to be an acceptable treatment alternative.
在本次综述中,我们评估了用于治疗牙周牙髓联合病变(EPL)的干预措施的临床疗效。
我们开展了一项临床随机对照试验的系统性综述。
共研究了 7 项临床试验。在这 7 项评估试验中的 6 项至少有一组研究同时进行了牙髓和牙周治疗。所有试验均显示研究组的探诊深度有所改善;然而,5 项研究的实验组在该参数上显示出统计学意义上的显著降低。临床附着水平也有所增加(<0.05)。大多数试验报告称,治疗后骨缺损的填充增加(<0.05)。与牙髓治疗同时进行的机械牙周治疗在治疗无交通的并发 EPL 方面显示出疗效。牙髓治疗和即刻牙周手术并不影响有根尖交通的联合 EPL 的处理结果。在牙周牙髓联合病变患者中,使用二极管激光、富血小板纤维蛋白(PRF)管理、钛制备 PRF 以及进行骨移植加牙髓治疗用矿物三氧化物或牙胶似乎是一种可行的策略。
同时进行牙髓和牙周治疗的牙周牙髓联合病变的治疗似乎是一种可接受的治疗选择。