The influence of endodontic infection on progression of marginal bone loss in periodontitis

Abstract

The purpose of the present investigation was to determine magnitude and rate of proximal radiographic attachment loss in relation to endodontic infection in periodontally involved teeth. The investigation was conducted as a retrospective longitudinal study on a periodontitis-prone randomly selected referral population, including 175 single-rooted, root-filled teeth in 133 patients. An observation period of at least 3 years was required. Periapical conditions of the selected sample at baseline and re-examination were evaluated on radiographs, independently by 3 investigators. Each single-rooted, root-filled tooth of the sample was given a score according to the combined registrations. Radiographic attachment level was measured as the distance between the most coronal point of the alveolar bone and the apex at the mesial and distal sides of the tooth, and expressed as relative radiographic attachment level (RRAL) (radiographic attachment level at baseline/root length) at proximal sites for every tooth. Multiple regression analysis was used to study change in RRAL over time. Teeth in periodontitis-prone patients with progressing periapical pathology indicating a continuous root canal infection were found to lose comparatively more radiographic attachment than teeth with no signs of periapical pathology or teeth with an established periapical destruction which subsided during the observation period. An approximate 3-fold amplification of the rate of marginal proximal radiographic bone loss by endodontic infection in periodontitis-prone patients was found with an average 0.19 mm/year, while 0.06 mm/year was lost for teeth without endodontic infection or subsiding endodontic involvement.

Prevalence and Quality of Endodontic Treatment in the Northern Manhattan Elderly

“…We found that the severity of marginal bone loss was positively correlated with the number and size of periapical radiolucencies. This finding is consistent with those of Jansson et al (33) and Ehnevid et al (34).…”

“…As was previously shown (33,34), periodontal disease measures appeared to influence endodontic treatment outcomes. Of the 3,533 teeth examined in this study, 11% had severe marginal bone loss.…”

A multiparametric evaluation of post-restored teeth with simulated bone loss

“…In a retrospective study, periodontal problem constituted 32% of the failures of post-endodontic teeth, which was even higher than the 8.6% of failures due to endodontic causes (Vire, 1991). Decay and trauma responsible to pulpitis, and irritation from endodontic medicates and filling materials have been attributed to the co-existence of periodontal disease (Jansson et al, 1995;Timmerman and Van der Weijden, 2006). Numerous investigations have reported the impact of the periodontal status on the survival of endodontically treated teeth (Komada et al, 2006;Naumann et al, 2006;Reinhardt et al, 1983).…”

Multidisciplinary Approach to the Conservative and Regenerative Management of Endo-Perio Lesion

“…The pathways for the spread of bacteria between pulpal and periodontal tissues have been discussed with controversy. [1,2,3] Pulpal infection can drain through the periodontal ligament space and give an appearance of periodontal destruction, termed retrograde periodontitis. Similarly, both pulpal and periodontal infections can coexist in the same tooth, termed combined lesions, where the treatment depends on the degree of involvement of the tissues.…”