Comparative evaluation of root canal treatment alone and in combination with periodontal flap surgery in the treatment of endodontic-periodontal lesions: Randomized controlled clinical trial

Background: Endodontic-periodontal lesions are described as the lesions due to inflammatory products found in varying degrees in both pulp and periodontal tissues. In all cases of concurrent periodontal and pulpal disorders, the clinician must determine whether the existing tissue change originated from one or both processes so that appropriate treatment could be initiated. Aims: The aim of the present randomized controlled clinical trial was to evaluate and compare the two treatment approaches for the treatment of primary endodontic lesions with secondary periodontal involvement, i.e., root canal treatment (RCT) with RCT and periodontal flap surgery. Subjects and Methods: In this study, twenty cases aged between 18 and 55 years with good systemic health diagnosed as cases of primary endodontic lesion with secondary periodontal involvement were selected for the study. In ten cases, only RCT was performed (control group), and in another ten, after 1 month of completion of RCT, periodontal flap surgery was performed (test group). The patients were evaluated for changes in the gingival index, plaque index, gingival bleeding index, probing depth (PD), and relative attachment level (RAL) at baseline, 1 month, and at 4 months postoperatively. Results and Conclusion: Results showed statistically significant (P < 0.05) reduction from baseline to 1 and 4 months in the PD and gain in RAL both on intergroup and intragroup comparison. Thus, from the results of the study, it could be concluded that both treatment approaches revealed a significant improvement in the PD reduction and attachment level gain 4 months postoperatively. However, test group showed a significant difference in the reduction of PD and gain in attachment level.