Periodontal healing in teeth with periapical lesions. A clinical retrospective study

The purpose of the present investigation was to compare clinical periodontal healing in periodontally involved teeth with and without pulpal pathosis. The investigation was conducted as a retrospective study on a consecutive referral population. The periapical conditions in endodontically involved single-rooted teeth from a selected patient sample were evaluated and correlated with their periodontal healing pattern. Multiple regression analysis of the registered variables showed that initial mean pocket depth and time elapsed after treatment significantly influenced change in pocket-depth. Non-surgical treatment of periodontal pockets exceeding 2.5 mm in teeth with horizontal marginal defects, over the observation period, showed significantly reduced mean pocket depth reduction in teeth with periapical pathology compared to teeth without periapical pathology. It was, furthermore, evident that proximal restorations, abutments for fixed bridges and root fillings with and without dowels did not significantly influence pocket depth reduction in the present material. It was concluded, based on the present results, that a root-canal infection, evident as a periapical radiolucency, if left untreated may in the long term perspective result in retarded or impaired periodontal healing following periodontal therapy and, consequently, should be given appropriate consideration when coordinating endodontic therapy and periodontal treatment.