Evaluation of the Prevalence of Endo-Periodontal Lesions According to the New Classification of Periodontal and Peri-Implant Diseases

Authors

DOI:

https://doi.org/10.58600/eurjther2755

Keywords:

panoramic radiography, peri-implant diseases, periodontal diseases, periodontitis, prevalence

Abstract

Objective: The study aimed to determine the prevalence of endo-periodontal lesions (EPL) in individuals with periodontitis, to evaluate these lesions according to the new Classification of Periodontal and Peri-Implant Diseases and Conditions (2017-Classification), and to investigate the relationship of EPLs with various parameters.

Methods: The files of patients diagnosed with periodontitis were retrospectively evaluated in terms of age, gender, periodontal disease stage, EPL grade, number of EPL, radiographic shape, oral location, caries, presence of restoration, and furcation involvement of the tooth with EPL.

Results: EPL was detected in 77 patients, consisted of 35 females and 42 males (mean age: 43.97±11.60), from a total of 800 patient files in the study. It was determined that the patients mostly received Stage III (n=43, 55.8%) in terms of periodontal diagnosis, and the teeth diagnosed with EPL had mostly Grade 3 (n=50, 64.9%) and cone-shaped (n=49, 63.6%) according to radiographic appearance. It was determined that EPL was mostly detected in mandibular molars (n=32, 41.6%), and the majority of teeth with EPL did not have root canal treatment (n=63, 81.8%), a prosthetic restoration (n=59, 76.6%), or caries (n=58, 75.3%). No significant difference was found between age groups and genders in terms of EPL number, grade, radiographic shape, and localization. In addition, there was no statistically significant difference between the number of teeth with EPL and the stage of periodontal disease.

Conclusion: Prevalence of EPL was 9.62% in this study. Within the limitations of this study, it can be stated that according to the 2017-Classification, the number, grade, radiographic shape, and localization of EPL in periodontitis patients did not differ according to gender and age ranges. EPL was observed more in Stage III periodontitis patients and in mandibular molar teeth, and the rate of EPL-Grade 3 and radiographic images with cone-shaped was higher in these patients.

References

Evans M (2023) The endodontic-periodontal juncture: Where two worlds meet. An overview of endo-perio lesions. Aust Dent J. 68 Suppl 1:S56–S65. https://doi.org/10.1111/adj.12993

Rotstein I (2017) Interaction between endodontics and periodontics. Periodontol 2000. 74:11–39. https://doi.org/10.1111/prd.12188

Ardila CM, Vivares-Builes AM (2022) Clinical Efficacy of Treatment of Endodontic-Periodontal Lesions: A Systematic Scoping Review of Experimental Studies. Int J Environ Res Public Health. 19:13649. https://doi.org/10.3390/ijerph192013649

Herrera D, Retamal-Valdes B, Alonso B, Feres M (2018) Acute periodontal lesions (periodontal abscesses and necrotizing periodontal diseases) and endo-periodontal lesions. J Periodontol. 89:S85–S102. https://doi.org/10.1002/JPER.16-0642

Gambin DJ, Vitali FC, Casanova KAS, DE Carli JP, Mazzon RR, Gomes BPFA, Trentin MS, Duque TM (2024) Prevalence of species of yellow, purple and green microbial complexes in endo-perio lesions: a systematic review. Braz Oral Res. 38:e048. https://doi.org/10.1590/1807-3107bor-2024.vol38.0048

Mahajan A, Razi MA, Kundu M, Qamar S, Chandra S, Deep A (2024) Comparative Evaluation of Microbial Flora of Endodontic Origin in Teeth with Endo-Perio Lesions. J Pharm Bioallied Sci. 16:S856–S858. https://doi.org/10.4103/jpbs.jpbs_1060_23

Al-Fouzan KS (2014) A new classification of endodontic-periodontal lesions. Int J Dent. 919173:1-5. https://doi.org/10.1155/2014/919173

Takahashi K, Yamazaki K, Yamazaki M, Kato Y, Baba Y (2022) Personalized Medicine Based on the Pathogenesis and Risk Assessment of Endodontic-Periodontal Lesions. J Pers Med. 12:1688. https://doi.org/10.3390/jpm12101688

Papapanou PN, Sanz M, Buduneli N, Dietrich T, Feres M, Fine DH, Flemmig TF, Garcia R, Giannobile WV, Graziani F, Greenwell H, Herrera D, Kao RT, Kebschull M, Kinane DF, Kirkwood KL, Kocher T, Kornman KS, Kumar PS, Loos BG, Machtei E, Meng H, Mombelli A, Needleman I, Offenbacher S, Seymour GJ, Teles R, Tonetti MS (2018) Periodontitis: Consensus report of workgroup 2 of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions. J Periodontol. 89:S173–S182. https://doi.org/10.1002/JPER.17-0721

Caton JG, Armitage G, Berglundh T, Chapple ILC, Jepsen S, Kornman KS, Mealey BL, Papapanou PN, Sanz M, Tonetti MS (2018) A new classification scheme for periodontal and peri-implant diseases and conditions-Introduction and key changes from the 1999 classification. J Clin Periodontol. 45:S1–S8. https://doi.org/10.1111/jcpe.12935

Kuoch P, Bonte E (2020) Endoperiodontal Lesions and Chicago’s New Classification of Periodontal and Peri-implant Diseases and Conditions. J Contemp Dent Pract. 21:798–802

Siddiqui AY, Radhan R, Almalki F, Alghamdi F, Alsubhi A, Alaamri A, Alzahrani KT (2022) Knowledge and awareness of Endo-Perio lesions among dentists and dental interns in Saudi Arabia. Med Sci. 26:1-8. https://doi.org/10.54905/disssi/v26i121/ms85e2121

Khandelwal A, Billore J, Gupta B, Jaroli S, Agrawal N (2020) Knowledge, attitude and perception on endo-perio lesions in practicing dentists- A qualitative research study. JAMDSR. 8:31–34. https://doi.org/10.21276/jamdsr

Ruetters M, Gehrig H, Kronsteiner D, Schuessler DL, Kim TS (2022) Prevalence of endo-perio lesions according to the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Disease in a university hospital. Quintessence Int. 53:134–142. https://doi.org/10.3290/j.qi.b2091245

Güneç HG, Paksoy T, Atalay C, Aydın K (2023) Retrospective evaluation of the prevalence of endodontic-periodontal lesions on panoramic images in the latest classification of periodontal and peri-implant diseases. J Health Sci Med. 6:737–744. https://doi.org/10.32322/jhsm.1293681

Altaf A, Jeelani M, Basher A (2019) Assessment of prevalence of Endo-perio lesions among patients of known population: An observational study. Int J Appl Dent Sci. 5:111–113

Qasım H, Karam B, Mousa H, Mohamed S (2023) Prevalence of Tooth Involved (Perio-Endo) Lesion Among Duhok Population: Across Sectional Study. JDU. 26:302–307. https://doi.org/10.26682/sjuod.2023.26.2.26

Slots J (2017) Periodontitis: facts, fallacies and the future. Periodontol 2000. 75:7–23. https://doi.org/10.1111/prd.12221

Gautam S, Galgali SR, Sheethal HS, Priya NS (2017) Pulpal changes associated with advanced periodontal disease: A histopathological study. J Oral Maxillofac Pathol. 21:58–63. https://doi.org/10.4103/0973-029X.203795

Simon JHS, Glick DH, Frank AL (1972) The Relationship of Endodontic-Periodontic Lesions. J Periodontol. 43:202–208. https://doi.org/10.1902/jop.1972.43.4.202

Dako T, Lazăr A, Mârṭu M, Lazăr L (2021) Prevalence of Endo-Perio Lesions Among Adult Patients. An Observational Study. Rom. J. Med. Dent. Educ.10:16–21

Abdullah R, Ayoub S (2023) Prevalence of true combined endodontic-periodontal lesions in adult patients with and without diabetes: A cross sectional survey. Int J Appl Dent. Sci. 9:316-319. https://doi.org/10.22271/oral.2023.v9.i1e.1699

Prashaanthi N, Rajasekar A, Shantha Sundari K (2021) Prevalence of Endo Perio Lesion - An Institutional Study. IJDOS. 8:2858–2862. https://doi.org/10.19070/2377-8075-21000580

Robo I, Heta S, Haxhiu E, Qirjazi B, Ostreni V (2022) Endo-perio Lesions — Radiographic Diagnosis of Specific Classifications. SN Compr Clin Med. 4:211. https://doi.org/10.1007/s42399-022-01291-1

Foce E, Ahmed HMA, Hashem AAR (2022) Classifications and Management of Endodontic-Periodontal Lesions. In: Ahmet HMA and Dummer PMH (eds) John Wiley & Sons, Ltd, pp 591–616.

Rotstein I, Simon JH (2004) Diagnosis, prognosis and decision-making in the treatment of combined periodontal-endodontic lesions. Periodontol 2000. 34:165-203. https://doi.org/10.1046/j.0906-6713.2003.003431

Sălceanu M, Melian A, Dascălu C, Giuroiu C, Concita C, Topoliceanu C, Melian D, Frumuzache A, Solomon SM, Mâr ̧tu MA (2025) Endo-Periodontal Lesions in Endodontically Treated Teeth with Periapical Pathology. Diagnostics (Basel) 15:1663. https://doi.org/10.3390/diagnostics15131663

Cucolo FCC, Bonvalente MC, Barroso EM, Toledo BECD, Camargo GADCG, Souza, AAE, Zuza EC (2021) Endo-perio lesions prevalence in non-molar and molar teeth: a pilot study. Rev odontol UNESP. 50:e20210037. https://doi.org/10.1590/1807-2577.03721

Figure 1. The flowchart of the study methodology

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Published

2025-09-22

How to Cite

Sari, E. T., & Altındal, D. (2025). Evaluation of the Prevalence of Endo-Periodontal Lesions According to the New Classification of Periodontal and Peri-Implant Diseases. European Journal of Therapeutics, 31(6), 376–388. https://doi.org/10.58600/eurjther2755

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