Exploring the Interdependence of Periodontal and Endodontic Health: A 3D Imaging Approach to Disease Progression and Microbial Dynamics: An Observational Study

Abstract

Background: The interdependence between periodontal and endodontic diseases is an area of increasing research interest. While both conditions were traditionally studied independently, recent studies suggest that microbial overlap and disease progression in one may influence the other. This study uses 3D imaging technology (CBCT) and microbiological analysis to explore this relationship in 200 participants with concurrent periodontal and endodontic involvement.

Objective: To evaluate the clinical, radiographic, and microbiological dynamics of periodontal and endodontic diseases, assess the interdependence of these conditions, and examine their progression over time using 3D imaging and microbial profiling.

Methods: A cohort of 200 participants aged 18-65 with both periodontal and endodontic diseases was enrolled. Clinical measurements, including probing depth and clinical attachment level, were recorded. Participants underwent cone-beam computed tomography (CBCT) scans to evaluate radiographic findings, including bone loss and periapical lesions. Microbial samples were collected from both periodontal pockets and root canal systems at baseline and after six months. Data were analyzed for microbial overlap, disease progression, and the relationship between periodontal and endodontic conditions.

Results: At baseline, 78% of participants exhibited microbial overlap, with Porphyromonas gingivalis, Enterococcus faecalis, and Prevotella intermedia being the most prevalent species in both periodontal and endodontic sites. Radiographic analysis revealed significant bone loss and periapical lesions in participants with severe periodontitis. After six months, significant disease progression was observed, including an increase in periodontal attachment loss (5.2 ± 2.4 mm to 6.1 ± 2.7 mm) and periapical lesion size (9.6 ± 4.1 mm² to 11.3 ± 5.4 mm²). Microbial dynamics showed increased persistence of key pathogens in both sites, particularly in individuals with higher baseline microbial loads.

Conclusion: This study demonstrates a significant interdependence between periodontal and endodontic diseases, with microbial overlap and disease progression in both areas. The findings suggest that 3D imaging and microbiological analysis are crucial tools in diagnosing and managing co-existing periodontal and endodontic conditions. An integrated treatment approach may be necessary for more effective management of these conditions.