TREATMENT OF ENDO-PERIODONTAL LESIONS: A SCOPE REVIEW

Abstract

Endo-periodontal lesions are destructive lesions that affect the tooth periodontal and pulp tissues. The diagnosis and treatment of these lesions represent a great challenge for clinical practice. Therefore, the aim of this review was to answer the following focused question: “Which are the treatment protocols for endo-periodontal lesions? A scoping review was conducted following the PRISMA-ScR statement.  The MEDLINE database (pubmed) was searched up to August 2020. Studies with any design that reported endodontic and periodontal treatment of at least one tooth with endo-periodontal lesion were included. The electronic search generated 238 titles/abstracts and 44 articles were included in this review. In total, 545 volunteers were included and 651 teeth with endo-periodontal lesions were diagnosed/treated. The most prevalent therapy observed in this study was conventional endodontic treatment, conducted before surgical periodontal therapy, followed by surgical endodontic treatment at the same time as surgical periodontal treatment, and to a lesser extent non-surgical periodontal therapy before endodontic therapy. There were no reports of cases where surgical periodontal treatment occurred before conventional endodontics treatment. In conclusion, the treatment of endo-periodontal lesions must involve both endodontic and periodontal therapy. Most of the reported cases started treatment using conventional endodontic treatment, followed by periodontal treatment (non-surgical and / or surgical). However, there is still controversy as to whether or not some time should be respected between the two treatments in order to allow a better tissue repair. Most teeth diagnosed with some type of endo-periodontal lesion and treated showed positive outcomes.