Division of Conservative Dentistry and Endodontics, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India, 110029.
Department of Biostatistics, All India Institute of Medical Science and Research, New Delhi, India, 110029.
Clin Oral Investig. 2024 Mar 15;28(4):217. doi: 10.1007/s00784-024-05611-8.
To investigate the influence of severity of periodontal disease on periapical healing after non-surgical endodontic therapy (NSET).
In this prospective study, subjects (n = 45) requiring NSET in a mandibular molar tooth with the diagnosis of pulp necrosis and asymptomatic apical periodontitis exhibiting radiographic periapical index (PAI) score ≥ 3 and concomitant endodontic periodontal lesion (CEPL) without communication were enrolled. After dividing as per the classification of Periodontal and Peri-Implant Diseases and Conditions, subjects were equally allocated into three groups. Group I- only endodontic lesion {control: healthy periodontium (n = 15)}, Group II- CEPL having stage I and II periodontitis (n = 15) and Group III- CEPL having stage III periodontitis (n = 15). Standardized two-visit NSET was performed with 2% chlorhexidine gel as an intracanal medicament. Periodontal therapy was instituted wherever required. Subjects were recalled at 6-and 12-months for clinical and radiographic assessment. Chi-square test was performed to evaluate the difference between the groups.
At 12-month follow-up, all teeth in the three study groups were asymptomatic. On radiographic evaluation of the periapical region, healing was observed in 80%, 47% and 50% of teeth in Groups I, Group II and Group III, respectively. However, the difference was not statistically significant between the groups (p = 0.150).
The severity of periodontal disease had no influence on periapical healing after NSET in teeth with concomitant endodontic periodontal lesions without communication.
Periodontal disease has significant impact on apical periodontitis however severity of the periodontitis does not negatively impact the apical periodontitis.
研究牙周病严重程度对非手术根管治疗（NSET）后根尖周愈合的影响。
在这项前瞻性研究中，纳入了需要在下颌磨牙中进行 NSET 的受试者（n=45），这些磨牙的诊断为牙髓坏死和无症状的根尖周炎，表现为放射影像学根尖指数（PAI）评分≥3 且伴有根管牙周病变（CEPL）但无沟通。根据牙周病和种植体周围病况的分类进行分组后，受试者被平均分为三组。I 组-仅存在牙髓病变{对照组：健康牙周组织（n=15）}，II 组-CEPL 存在 I 期和 II 期牙周炎（n=15），III 组-CEPL 存在 III 期牙周炎（n=15）。用 2%洗必泰凝胶作为根管内药物进行标准化的两访次 NSET。在需要的情况下进行牙周治疗。在 6 个月和 12 个月时进行临床和放射影像学评估以进行随访。采用卡方检验评估组间差异。
在 12 个月的随访中，三组所有牙齿均无症状。在根尖区域的放射影像学评估中，I 组、II 组和 III 组的牙齿分别有 80%、47%和 50%观察到愈合。然而，组间差异无统计学意义（p=0.150）。
在无沟通的伴有根管牙周病变的牙齿中，牙周病的严重程度对 NSET 后根尖周愈合无影响。
牙周病对根尖周炎有显著影响，但牙周炎的严重程度不会对根尖周炎产生负面影响。
