Prognostic Assessment of Tooth Survival After Treatment of Endodontic-Periodontal Lesions: A Retrospective Study

IF 8.3 1区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of Clinical Periodontology Pub Date : 2026-07-15 Epub Date: 2026-05-19 DOI:10.1111/jcpe.70142

Fumihiko Kimura, Risako Mikami, Koji Mizutani, Daisuke Kido, Kohei Takeda, Keita Nakagawa, Shu Takemura, Hiromi Kominato, Natsumi Saito, Tatsuro Seike, Eri Sakaniwa, Ayu Sugiyama, Tomoki Nogami, Satoshi Watanabe, Jun Aida, Takanori Iwata

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Abstract

Aim

This retrospective cohort study aimed to identify pretreatment prognostic factors for tooth survival in teeth with endodontic-periodontal lesions (EPLs).

Materials and Methods

Teeth with EPLs treated according to a standardised clinical protocol involving periodontal and endodontic treatments were included. Clinical parameters were measured, and the EPL grade was classified according to the 2017 World Workshop criteria. Based on the radiographic characteristics, lesions were categorised as I-shaped (unilateral intrabony defect without apparent apical radiolucency), J-shaped (unilateral intrabony defect with apical radiolucency) and U-shaped (bilateral intrabony defects with apical radiolucency). Survival-time analysis was performed.

Results

Of the 187 teeth included, 117 survived over the mean observation period of 3.1 ± 2.1 years (maximum, 8.4 years). The estimated 1- and 5-year tooth survival rates were 83.8% and 58.9%, respectively. Multivariate analysis identified age, EPL grade, probing depth (PD), periapical index, bone loss and I-J-U subclassification as significant prognostic factors for tooth survival. The I-J-U subclassification was significantly associated with tooth survival, suggesting its potential value in prognostic assessment.

Conclusion

This retrospective cohort study identified age, EPL grade, PD and radiographic shape of bone loss as predicting factors for tooth survival in teeth with EPLs.

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牙髓-牙周病变治疗后牙齿存活的预后评估：一项回顾性研究。

目的：本回顾性队列研究旨在确定影响牙髓-牙周病变（epl）患者牙齿存活的预处理预后因素。材料和方法：根据包括牙周和牙髓治疗在内的标准化临床方案治疗epl的牙齿。测量临床参数，并根据2017年世界研讨会标准进行EPL分级。根据影像学特征，将病变分为i型（单侧骨内缺损无明显根尖透光）、j型（单侧骨内缺损有根尖透光）和u型（双侧骨内缺损有根尖透光）。进行生存时间分析。结果：187颗牙中117颗存活，平均观察期3.1±2.1年，最长8.4年。估计1年和5年牙齿存活率分别为83.8%和58.9%。多因素分析发现，年龄、EPL分级、探查深度（PD）、根尖周指数、骨质流失和I-J-U亚分类是影响牙齿存活的重要预后因素。I-J-U亚分类与牙齿存活显著相关，提示其在预后评估中的潜在价值。结论：本回顾性队列研究确定年龄，EPL分级，PD和骨丢失的x线形状是EPL牙齿存活的预测因素。

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来源期刊

Journal of Clinical Periodontology 医学-牙科与口腔外科

CiteScore

13.30

自引率

10.40%

发文量

175

审稿时长

3-8 weeks

期刊介绍： Journal of Clinical Periodontology was founded by the British, Dutch, French, German, Scandinavian, and Swiss Societies of Periodontology. The aim of the Journal of Clinical Periodontology is to provide the platform for exchange of scientific and clinical progress in the field of Periodontology and allied disciplines, and to do so at the highest possible level. The Journal also aims to facilitate the application of new scientific knowledge to the daily practice of the concerned disciplines and addresses both practicing clinicians and academics. The Journal is the official publication of the European Federation of Periodontology but wishes to retain its international scope. The Journal publishes original contributions of high scientific merit in the fields of periodontology and implant dentistry. Its scope encompasses the physiology and pathology of the periodontium, the tissue integration of dental implants, the biology and the modulation of periodontal and alveolar bone healing and regeneration, diagnosis, epidemiology, prevention and therapy of periodontal disease, the clinical aspects of tooth replacement with dental implants, and the comprehensive rehabilitation of the periodontal patient. Review articles by experts on new developments in basic and applied periodontal science and associated dental disciplines, advances in periodontal or implant techniques and procedures, and case reports which illustrate important new information are also welcome.