Endodontic-Periodontal Interactions and Management
Summary
Endodontic‐periodontal interactions encompass the complex relationships between the dental pulp and the surrounding periodontal tissues. Anatomical pathways such as lateral canals, dentinal tubules and apical foramina permit bidirectional communication, enabling microbial migration and inflammatory mediators to traverse between the pulp chamber and periodontal pocket. Clinically, these connections give rise to combined lesions that present diagnostic challenges, as symptoms and radiographic features may overlap. Classification schemes distinguish primary endodontic, primary periodontal, and true combined lesions, guiding treatment sequencing and prognosis. Successful management demands a multidisciplinary strategy: eradication of endodontic infection through disinfection and obturation; resolution of periodontal pathology via debridement, regenerative techniques and maintenance of optimal oral hygiene; and in complex cases, adjunctive use of bone grafts, barrier membranes or lasers to promote tissue regeneration. Advances in imaging, molecular diagnostics and biomaterials have refined the capacity to identify lesion origin, assess healing and tailor interventions. Globally, standardisation of diagnostic protocols and evidence‐based therapeutic algorithms is envisaged to improve outcomes and reduce tooth loss in populations affected by endodontic‐periodontal disease.
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Endodontic-Periodontal Interactions and Management publication trend
The graph below shows the total number of articles in endodontic-periodontal interactions and management across all publications each year (not limited to Nature Index journals).
Technical terms
Endo‐periodontal lesion: A pathological communication involving both the dental pulp and the periodontium.
Periodontium: The supporting structures of the tooth, including gingiva, periodontal ligament, cementum and alveolar bone.
Root canal therapy: A procedure to remove infected or necrotic pulp tissue, disinfect the canal system and seal it to prevent reinfection.
Probing depth (PD): The distance from the gingival margin to the base of the periodontal pocket, measured with a periodontal probe.
Clinical attachment level (CAL): The position of the attached periodontal tissues relative to a fixed reference point on the tooth, indicating cumulative tissue loss.
References
- Expert consensus on the diagnosis and therapy of endo-periodontal lesions. International Journal of Oral Science (2024).
- Analysis of oral microbiota in non-vital teeth and clinically intact external surface from patients with severe periodontitis using Nanopore sequencing: a case study. Journal of Oral Microbiology (2023).
- Clinical Efficacy of Treatment of Endodontic-Periodontal Lesions: A Systematic Scoping Review of Experimental Studies. International Journal of Environmental Research and Public Health (2022).
- A New Classification of Endodontic‐Periodontal Lesions. International Journal of Dentistry (2014).
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