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Table of Contents
Year : 2022  |  Volume : 10  |  Issue : 4  |  Page : 85-87

Assessment of correlation of periodontal pathogens in endoperio lesions

1 Department of Periodontology & Implantology, Siddhpur Dental College and Hospital, Siddhpur, Gujarat, India
2 Department of Conservative Dentistry and Endodontics, Pacific Dental College & Hospital, Udaipur, Rajasthan, India
3 Department of Conservative Dentistry and Endodontics, Siddhpur Dental College and Hospital, Siddhpur, Gujarat, India
4 Department of Endodontics, Siddhpur Dental College and Hospital, Siddhpur, Gujarat, India
5 Department of Periodontology, Siddhpur Dental College and Hospital, Siddhpur, Gujarat, India
6 Department of Orthodontics, Siddhpur Dental College and Hospital, Siddhpur, Gujarat, India

Date of Submission17-Dec-2022
Date of Acceptance19-Dec-2022
Date of Web Publication30-Dec-2022

Correspondence Address:
Dr. Rohit R Thakkar
Department of Periodontology, Siddhpur Dental College and Hospital, Siddhpur 384151, Gujarat
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/INJO.INJO_28_22

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Background: There is still debate concerning the path of infection inside the endodontic-periodontal niche since it is not obvious if the bacterial migration takes place via dentinal tubules. Aim: With endodontic periodontal disorders, this research sought to link periodontal pathogens. Materials and Methods: A total of 100 patients of the two sexual orientations participated in this research. Every single member of the group was recruited from the endodontics and periodontology fields and had a history of endoperio sores on the same teeth. Relationships were established and a polymerase chain reaction was conducted. Results: Our findings indicate that out of 100 patients, 68 were men and 32 were women. The average lifespan for men was 35 years, whereas the average lifespan for women was 30 years. Result shows that isolates of Tannerella forsythia, Porphyromonas gingivalis, and Aggregatibacter actinomycetemcomitans were found in 95% endodontium and 92% periodontium, 13% endodontium, and 58% periodontium, respectively. Conclusion: In parallel endodontic and periodontal diseases, the levels of the targeted bacterial species correlated. Thus, it is conceivable to hypothesize that dentinal tubules act as a pathway for the spread of bacteria.

Keywords: Endodontic-periodontal diseases, Porphyromonas gingivalis, Tannerella forsythia

How to cite this article:
Kalvani H, Babulal H, Kalburge VJ, Chaudhary N, Thakkar RR, Ahir JD. Assessment of correlation of periodontal pathogens in endoperio lesions. Int J Oral Care Res 2022;10:85-7

How to cite this URL:
Kalvani H, Babulal H, Kalburge VJ, Chaudhary N, Thakkar RR, Ahir JD. Assessment of correlation of periodontal pathogens in endoperio lesions. Int J Oral Care Res [serial online] 2022 [cited 2023 Mar 24];10:85-7. Available from: https://www.ijocr.org/text.asp?2022/10/4/85/366319

  Introduction Top

The highest level of periodontal therapy used to be scaling and root planning, which included removing contaminated cementum as a prerequisite. In the field of endodontics and periodontics, the question of whether or not disease spreads by bacterial migration in dentinal tubules is still up for dispute. Cement is used to seal up the dentinal tubule openings that are exposed to the periodontal ligament. Clinical, excessive, and erosive cycles are able to precisely remove, rub, break apart, and dissolve dentinal cementum. Dentinal tubule infection is not universally recognized as a condition that requires an endodontist or periodontist’s expertise because of the possibility of debate around the matter.[1],[2],[3],[4],[5] The development of microorganisms from the outside root surface to the root stream construction may aid the storage effect of the tubules, even if cementum acts as an impediment to bacterial transportation via dentinal tubules. The dentinal tubules’ capacity for permeation may depend on the size of the tiny organisms, the characteristics of the concrete, and how mobile they are. Thus, this depends on the patient’s age and the condition of their various dental locations. The collaboration of irresistible natural compounds in endodontic and periodontal strength has previously been the focus of a few approaches. Microorganisms, bacterial bioproducts, and other types of pollutants may all cause substantial insusceptible reactions. Microorganisms may enter the two categories via their dentinal tubules and proliferate the endodontic and periodontal tissues, as has been demonstrated.[6],[7],[8],[9],[10] Given this, we anticipated that our investigation would link periodontal microscopic organisms to endodontic periodontal infections.

  Materials and Methods Top

For this examination, the Endodontics and Periodontology Branch was in charge. To gather recommendations for moral behavior, organized institutional moral boards were used. Each patient was given information regarding the level of the substance in their particular tongue, and their informed consent was obtained. All procedures performed in the study were conducted in accordance with the ethics standards given in 1964 Declaration of Helsinki, as revised in 2013. The study proposal was submitted for approval and clearance was obtained from the ethical committee of our institution. A written informed consent was obtained from each participant. Forty patients of both sexes, one of whom had endodontic or periodontal disease, and all of whom had periodontal pockets of less than 6 mm, were included in the study. Patients were discouraged from receiving therapy if they had a fistula, radiographic evidence of endodontic-peridontal correspondence, severe periodontitis, or a history of using anti-toxins during the previous 90 days. If a certain sequence of interactions went as planned, patient data, including name, age, location, and other details, were stored. All patients had intraoral periapical radiographs performed in order to determine if endodontic-peridontal bruises were present. For each of the various periodontal instances, a few paper centers were inserted into the periodontal pockets and preserved there for a short time each. Different examinations of teeth with a single root canal were conducted using the strict aseptic technique. A few sterile paper centers were placed in the root hole and then left for a short while. Then, 1 mL of TE was placed in cryotubes, which included the study’s major findings. The samples were flash frozen and stored at a constant temperature of 80°C. To prepare for DNA extraction, frozen endodontic and periodontal samples were thawed and resuspended at room temperature. Qiamp DNA was scaled down to make this system (Qiagen, Hilden, Germany). The spectrophotometer 1240, which blocks UV light, was used to analyze DNA concentration and purity. Tansy forsythia, in advance 5, GCG, TAT Canada’s Greater Toronto Area Academic and Cultural Community There is a 3’-Tf switch and a 5’-TGC. “The exact number of DNA copies in the bacterium was calculated using an indirect evaluation method. Porphyromonas gingivalis ATCC 33277, Tannerella forsythia ATCC 43037, and Aggregatibacter actinomycetemcomitans ATCC 29523 all came from the American Type Culture Collection (ATCC; Manassas, Virginia).” We used the SPSS software program, version 21.0.0 (SPSS, Chicago, Illinois) to organize and comprehensively analyze the data we collected in this manner. A significance level of 0.05 was used for the Student’s t test.

  Results Top

Our research revealed that 32 of the 100 patients were women and 68 were men. The average lifespan for men was 35 years, whereas the average lifespan for women was 30 years. Samples of T. forsythia are shown in [Table 1]. Forsythia was isolated from 95% of the endodontium, 92% of the periodontium, 75% of the P. gingivalis, and 50% of the A. actinomycetemcomitans. 58% of periodontal tissue and 13% of endodontic tissue are the sources of Aggregatibacter actinomycetemcomitans (P = 0.05). The distinction was significant. For a given tooth, there was no significant difference in the total number of identified microorganisms between the endodontium and the periodontium. [Table 2] shows a significant correlation between the presence of T. forsythia and the presence of P. gingivalis (r = 0.501 and P = 0.05), P. gingivalis, and A. actinomycetemcomitans (r = 0.618 and P = 0.05), and T. forsythia and A. actinomycetemcomitans (r = 0.491 and P = 0.05).”
Table 1: Detected species in endodontion and periodontium

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Table 2: Pearson’s correlation between bacterial species of same tooth

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  Discussion Top

A favorable factual link between the straightforward quantification of the specified species and the rise of pocket profundity was not seen since the estimated profundity was less than 6 mm. The fact that both endodontic and periodontal therapies often include the coronal and central component of the root as a bacterial route necessitated this restriction. According to the Pearson test results, the strong quantifiable correlations of T. forsythia, F. nucleatum, and P. gingivalis quantification in periodontal pockets provide the best possible natural circumstances for bacterial development in these pockets. On the contrary, comparable stressors from the same tooth’s root canal led to a noticeably smaller connection. Because a synergistic interaction between these organisms may rely less on the status of the root canal than on periodontal specialization, our results emphasize the ecological effect on bacterial proliferation. One reason endodontists do not withdraw waterway filling for all endodontic infections is that there may be hazy microorganisms present in the root channel due to external influences and situations.[10],[11],[12],[13],[14],[15] It was hoped that this study will link periodontal microorganisms with endodontic periodontal disorders. A review led by Lačević et al.[6] examined the presence of T. forsythia, P. gingivalis, F. nucleatum, and A. actinomycetemcomitans at several places in patients experiencing both endodontic and periodontal problems. In their study, they did not find a significant difference in the total number of endodontic-periodontal bacteria between the endodontium and the periodontium. For example, the Pearson test distinguished between endodontic-periodontal injuries and the specific bacteria T. forsythia, F. nucleatum, and P. gingivalis (P = 0.001). Similar teeth were found to have no discernible difference in the levels of certain bacteria in their endodontiums and periodontiums across the two time periods analyzed. We discovered a fundamental link between the bacteria in endodontic-peridontal disease after comparing P. gingivalis and A. actinomycetemcomitans, T. forsythia and A. actinomycetemcomitans, and A. actinomycetemcomitans and T. forsythia. According to Abbot and Salgado,[8] bacteria entering the root trench via the apical foramen may cause periodontal disease. These germs may contribute to the development of periodontitis by disseminating along these pathways or through dentinal tubules. The mesenchymal tissues of the tooth microflora, which include the mastication and periodontal tissues, are very vascular. These tissues get blood supply from the apical foramen and equal channels of the developing tooth. For the periodontium to communicate with the mammary gland, the apical foramen is the primary and most direct pathway. As a result, it is one of the regimens that is considered to be favorable for endoperio lesions.[12] Compared to teeth, connected sores have a more interesting microbiota due to the restricted periapical pathosis.[13] Due to the many decorative channels found in multirooted teeth like premolars and molars, endoperio ulcers are quite prevalent. Double destinations disease may spread and is maintained via the coronal and cervical dentinal tubules. When administered at the appropriate time, both end-of-cycle therapies are more efficient and have higher rates of non-intrusive compliance.[14] The development of guess is aided by the use of oral prevention measures along with early diagnosis and treatment that consider important aspects. Healthy teeth are maintained with early important thinking. It has been shown that effective endodontic treatment in conjunction with authoritative periodontal therapy is the only way to successfully treat active periodontal disease.[15] A flaw in the present review is the absence of patients. The selection of several endoperio sore instances may have helped to clarify the harm that bacteria may wreak.

  Conclusion Top

Coronal and cervical dentinal tubules may be a practical route for the distribution and maintenance of multiple-site disease, as shown by a relationship between the levels of the identified bacterial species from concurrent endodontic and periodontal disorders. The periodontal microorganisms discovered in the root trench of concurrent endodontic and periodontal illnesses may have their origins in the adjacent periodontal sores.

Financial support and sponsorship

Not applicable.

Conflicts of interest

There are no conflicts of interest.

  References Top

Zehnder M, Gold SI, Hasselgren, G Pathologic interactions in pulpal and periodontal tissues. J Clin Periodontol 2002;29:663-71.  Back to cited text no. 1
Anderson AC, Al-Ahmad A, Elamin F, Jonas D, Mirghani Y, Schilhabel M, et al. Comparison of the bacterial composition and structure in symptomatic and asymptomatic endodontic infections associated with root-filled teeth using pyrosequencing. PLoS One 2013;8:e84960.  Back to cited text no. 2
Wang HL, Glickman GN Endodontic and periodontic inerrelationships. In: Cohen S, Burns RC, editors. Pathways of the Pulp. 8th ed. St Louis: CV Mosby; 2002. p. 651-66.   Back to cited text no. 3
Khatib MS, Devarasanahalli SV, Nadig RR Endoperio lesions: A diagnostic dilemma. Indian J Multidiscip Dent 2018;8:128-31.  Back to cited text no. 4
Setzer FC, Shah SB, Kohli MR, Karabucak B, Kim S Outcome of endodontic surgery: A meta-analysis of the literature – Part 1: Comparison of traditional root-end surgery and endodontic microsurgery. J Endod 2010;36:1757-65.  Back to cited text no. 5
Lačević A, Foschi F, Pojskić L, Pojskić N, Bajrović K, Izard J Correlation of periodontal pathogens in concurrent endodonticperiodontal diseases. Oral Biol Dent. 2015;3:551-6.   Back to cited text no. 6
Sistla KP, Raghava KV, Narayan SJ, Yadalam U, Bose A, Roy PP Endoperio continuum: A review from cause to cure. J Adv Clin Res Insights 2018;5:188-91.  Back to cited text no. 7
Abbot PV, Salgado JC Strategies for the endodontic managment of concurrent endodontic and periodontal diseases. Aust Dent J 2009;54:S70-85.  Back to cited text no. 8
Krupali S, Vimala N, Naykodi T, Dharmadikari S, Padhye P Endo perio restorative continuum: A case report. Int J Oral Health Dent 2016;2:265-7  Back to cited text no. 9
Tewari S, Sharma G, Tewari S, Mittal S, Bansal S Effect of immediate periodontal surgical treatment of periodontal healing in combined endodontic–periodontal lesions with communication: A randomized clinical trial. J Oral Biol Craniofac Res 2018;8:105-12.   Back to cited text no. 10
Saha AP, Chakraborty A, Saha S Endodontic-periodontal lesion: A two-way traffic. Int J Appl Dent Sci 2018;4:223-8.   Back to cited text no. 11
Harrington GW, Steiner DR Periodontal-endodontic considerations. In: Walton RE, Torabinejad M, editors. Principles and Practice of Endodontics. 3rd ed. Philadelphia, PA and London: Saunders; 2002. p. 466-84.   Back to cited text no. 12
Socransky S SHaffajee AD Dental biofilms: Difficult therapeutic targets. Periodontol 2002;28:12-55.  Back to cited text no. 13
Siqueira JF Jr. Taxonomic changes of bacteria associated with endodontic infections. J Endod 2003;29:619-23.  Back to cited text no. 14
Villanueva LECP Fusobacterium nucleatum in endodontic flare-ups. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2002;93:179-83.  Back to cited text no. 15


  [Table 1], [Table 2]


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