Regenerative Therapy Modality for Treatment of True Combined Endodontic-Periodontal Lesions: A Randomized Controlled Clinical Trial

Reham AlJasser; Sundus Bukhary; Mohammed AlSarhan; Dalal Alotaibi; Saleh AlOraini; Syed Rashid Habib

doi:10.3390/ijerph18126220

Regenerative Therapy Modality for Treatment of True Combined Endodontic-Periodontal Lesions: A Randomized Controlled Clinical Trial

Int J Environ Res Public Health. 2021 Jun 8;18(12):6220. doi: 10.3390/ijerph18126220.

Authors

Reham AlJasser¹, Sundus Bukhary², Mohammed AlSarhan¹, Dalal Alotaibi¹, Saleh AlOraini¹, Syed Rashid Habib³

Affiliations

¹ Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh 11545, Saudi Arabia.
² Division of Endodontics, Department of Restorative Dental Science, College of Dentistry, King Saud University, Riyadh 11545, Saudi Arabia.
³ Department of Prosthetic Dental Sciences, College of Dentistry, King Saud University, Riyadh 11545, Saudi Arabia.

Abstract

The aim of this in-vivo study was to evaluate/compare the clinical periodontal parameters in patients with true combined endo-perio lesions (EPL), treated with gutta-percha (GP) and mineral trioxide (MTA) as an obturation material alone and with addition of bone grafting in such lesions. 120 Saudi patients (mean age = 41yrs) diagnosed with true combined EPL participated in this study. Group I (control group, n = 30) was treated with conventional endodontic treatment using GP for obturation. Group II (n = 30) was treated with conventional endodontic treatment using MTA for obturation. Group III (n = 30) was treated with conventional endodontic treatment using GP for obturation + grafting procedure to fill the bony defect. Group IV (n = 30) was treated with conventional endodontic treatment using MTA for obturation + grafting procedure to fill the bony defect. Clinical parameters (Pocket depth (PD); Clinical attachment loss (CAL); keratinized tissue width (KTW); gingival phenotype (G.Ph.) and Cone Beam Computed Tomography Periapical Index (CBCTPAI)) were recorded and compared at baseline, 3, 6, 12 months' interval. For the groups III and IV, CBCTPAI showed significant difference (p < 0.0001) with the other groups at 6 months and 1-year interval. The group with MTA + bone graft showed 76% and 90% patients with 0 score at 6 months and 1-year follow-up, respectively. Comparison of mean values of PD among study groups at 3 months, 6 months and 1 year showed significant difference at 3 months, whereas the mean PD values of subjects in GP + bone graft showed significantly higher PD values than other 3 groups (p = 0.025). Use of GP and MTA for root canal obturation along with periodontal therapy and bone augmentation helps in resolving complex endo-perio lesions. Bone grafting in addition to obturation with MTA was found to be the best treatment strategy in management of EPL cases and is recommended for clinicians who are treating EPL patients.

Trial registration: ClinicalTrials.gov NCT04274498.

Keywords: MTA; bone grafting; endo-perio lesions; endodontic therapy; mineral trioxide; periodontal therapy.

Publication types

Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Adult
Aluminum Compounds
Calcium Compounds / therapeutic use
Drug Combinations
Humans
Oxides
Root Canal Filling Materials* / therapeutic use
Silicates / therapeutic use

Substances

Aluminum Compounds
Calcium Compounds
Drug Combinations
Oxides
Root Canal Filling Materials
Silicates

Associated data

ClinicalTrials.gov/NCT04274498