Soman Drisya, Nayak Moksha, Cm Mahesh, Radhakrishnan Rahul, G Praveena, Kurup Nisha B
Department of Conservative Dentistry and Endodontics, Azeezia College of Dental Sciences and Research, Kollam, IND.
Department of Conservative Dentistry and Endodontics, KVG Dental College and Hospital, Sullia, IND.
Cureus. 2025 Aug 26;17(8):e91075. doi: 10.7759/cureus.91075. eCollection 2025 Aug.
Endodontic-periodontal lesions are infections that simultaneously affect the pulp and periodontal tissues, often leading to complex clinical presentations. , a key periodontal pathogen, has also been identified in root canal infections, suggesting a potential role in the severity and progression of endodontic-periodontal lesions. Its virulence factors contribute to tissue destruction, inflammation, and immune modulation. However, data correlating its presence with specific clinical signs and symptoms in endodontic-periodontal lesions remain limited. This study aims to evaluate the presence of and its association with clinical and radiographic parameters in endodontic-periodontal lesions.
Clinical and radiographic findings considered for the diagnosis of endodontic-periodontal lesions were recorded from 32 patients, following which root canal samples were obtained and transported for identification of by culture. Fifteen root canal samples positive for species confirmed by culture were considered for the study. The results were assigned, and statistical analysis was done using the chi-square test, Fisher's exact test, and the Mann-Whitney U test.
was detected in 46.9% (15/32) of endodontic-periodontal lesions. Among -positive cases, the sinus tract was present in 66.7% (2/3), swelling in 71.4% (5/7), tenderness on percussion in 46.9% (15/32), and discoloration in 60% (3/5). The organism was more frequent in symptomatic cases (65.5%; 15/23), with statistically significant associations observed for pain ( < 0.05) and furcation involvement (88.9%; 8/9; < 0.05). On periodontal evaluation, -positive patients had greater mean pocket depth (5.33 mm) and attachment loss (4.93 mm) compared to negative patients ( < 0.05). Higher PAI scores (≥4) were recorded in 80% (12/15) of positive cases, with score 5 in 53% (8/15), score 4 in 26.7% (4/15), and score 3 in 20% (3/15). Periapical lesion size between 3 and 5 mm was observed in 60% (9/15) of positive cases, while 40% (6/15) had lesions >5 mm, showing a significant association with presence ( = 0.001).
is strongly associated with clinical signs and symptoms and its detection frequency positively correlates with the severity of endodontic-periodontal lesions.
牙髓牙周联合病变是同时影响牙髓和牙周组织的感染性疾病,常导致复杂的临床表现。牙龈卟啉单胞菌作为一种关键的牙周病原体,在根管感染中也有发现,提示其在牙髓牙周联合病变的严重程度和进展中可能发挥作用。其毒力因子可导致组织破坏、炎症和免疫调节。然而,关于其在牙髓牙周联合病变中与特定临床体征和症状相关性的数据仍然有限。本研究旨在评估牙龈卟啉单胞菌在牙髓牙周联合病变中的存在情况及其与临床和影像学参数的关系。
记录32例牙髓牙周联合病变患者用于诊断的临床和影像学检查结果,随后获取根管样本并送检,通过培养鉴定牙龈卟啉单胞菌。本研究纳入了15例经培养确诊为牙龈卟啉单胞菌属阳性的根管样本。对结果进行赋值,并采用卡方检验、Fisher精确检验和Mann-Whitney U检验进行统计分析。
在46.9%(15/32)的牙髓牙周联合病变中检测到牙龈卟啉单胞菌。在牙龈卟啉单胞菌阳性病例中,66.7%(2/3)有窦道,71.4%(5/7)有肿胀,46.9%(15/32)有叩痛,60%(3/5)有牙齿变色。该菌在有症状的病例中更常见(65.5%;15/23),疼痛(P<0.05)和根分叉病变(88.9%;8/9;P<0.05)与之有统计学意义的关联。牙周评估显示,与阴性患者相比,牙龈卟啉单胞菌阳性患者的平均牙周袋深度(5.33mm)和附着丧失(4.93mm)更大(P<0.05)。80%(12/15)的阳性病例PAI评分较高(≥4),其中5分占53%(8/15),4分占26.7%(4/15),3分占20%(3/15)。60%(9/15)的阳性病例根尖周病变大小在3至5mm之间,40%(6/15)的病变>5mm,与牙龈卟啉单胞菌的存在有显著关联(P=0.001)。
牙龈卟啉单胞菌与临床体征和症状密切相关,其检出频率与牙髓牙周联合病变的严重程度呈正相关。