Annex 5 (A5). Supplemental tables: Endo-Periodontal Lesion.

Table A5.1. Risk factors reported in the studies, stratified by study design.

Risk factors (% of studies according to each design)

Number Number of
Study Porcelain-
of Reference teeth Furcation Post- Carious
design Grooves Trauma fused-to- Periodontitis
studies included involvement preparation lesions
metal crowns

Clinical Didilescu 1, Gomes 2, Kipioti 3,

7 170 0.0 0.0 0.0 0.0 0.0 0.0 100
study Kobayashi 4, Li 5, Pereira 6, Rupf 7

Asgary 8, Attam 9, Ballal 10, Blanchard

11
, Castelo-Baz 12, Coraini 13, Floratos
14
, Gandhi 15, Goyal 16, Kambale 17,
Case
20 Karabucak 18, Kerezoudis 19, Kishan 30 50.0 20.0 20.0 20.0 10.0 10.0 0.0
report 20
, Mali 21, Miao 22, Oh 23, Pickel 24,
Sharma 25, Tobón-Arroyave 26, White
27

FINAL TOTAL Number of studies: 27 200 37.0 14.8 14.8 14.8 7.4 7.4 25.9

Table A5.2. Studied that evaluated the microbiota of endo-periodontal lesions.

 Number of Periodontitis
Reference Study design Technique Main finding
teeth studied patient
The majority of isolates in periodontal pockets and root canals were
Kipioti 3 Clinical study 16 Culture Yes Bacteroides gingivalis (currently Porphyromonas gingivalis) and Bacteroides
melaninogenicus ss intermedius (currently Prevotella intermedia).
The predominant bacterial species in periodontal pockets and root canals
Kobayashi 4 Clinical study 15 Culture Yes were from the genera Streptococcus, Peptostreptococcus, Eubacterium,
Bacteroides, Fusobacterium, Actinomyces and Streptococcus.
The most prevalent species in periodontal pockets and root canals were
Pereira 6 Clinical study 27 Culture/ PCR Yes
Porphyromonas gingivalis, Prevotella intermedia and Prevotella nigrescens.
The predominant bacterial species in periodontal pockets and root canals
PCR/Checkerboard
were Fusobacterium nucleatum, Campylobacter rectus, Eubacterium
Didilescu 1 Clinical study 46 DNA-DNA Yes
nodatum, Eikenella corrodens, Parvimonas micra and Capnocytophaga
Hybridization
sputigena.
The similarity of bacteria in dental plaque and necrotic pulp ranged from
13.1% to 62.5%. The main genera identified in dental plaque were
PCR/ DGGE, cloning
Xia 28 Clinical study 13 No Campylobacter, Fusobacterium, Neisseria, Peptostreptococcus, Veillonella,
and sequencing
Aggregatibacter, Enterobacter and Haemophilus, and in necrotic pulps were
Mogibacterium, Corynebacterium, Neisseria and Actinomyces
The predominant bacterial species in periodontal pockets and root canals
PCR/ DGGE, cloning
Li 5 Clinical study 20 Yes were Filifactor alocis, Parvimonas micra, Porphyromonas gingivalis and
and sequencing
Tannerella forsythia.
The most prevalent bacterial species in periodontal pockets and root canals
were Aggregatibacter actinomycetemcomitans, Tannerella forsythia,
Rupf 7 Clinical study 31 Real Time PCR Yes
Eikenella corrodens, Fusobacterium nucleatum, Prevotella intermedia,
Porphyromonas gingivalis and Treponema denticola.
Enterococcus faecalis, Parvimonas micra, Filifactor alocis were among the
most prevalent species in both root canals and periodontal pockets. Other
Next Generation
Gomes 2 Clinical study 15 Yes species were also predominant in root canals (Mogibacterium timidum,
Sequencing
Fretibacterium fastidiosum) or in periodontal pockets (Streptococcus
constellatus, Eubacterium brachy, Tannerella forsythia).
PCR: Polymerase Chain Reaction, DGGE: denaturing gradient gel electrophoresis
REFERENCES

1. Didilescu AC, Rusu D, Anghel A, et al. Investigation of six selected bacterial species in endo-periodontal lesions. Int Endod J 2012;45:282-293.
2. Gomes BP, Berber VB, Kokaras AS, Chen T, Paster BJ. Microbiomes of Endodontic-Periodontal Lesions before and after Chemomechanical
Preparation. J Endod 2015;41:1975-1984.
3. Kipioti A, Nakou M, Legakis N, Mitsis F. Microbiological findings of infected root canals and adjacent periodontal pockets in teeth with advanced
periodontitis. Oral Surg Oral Med Oral Pathol 1984;58:213-220.
4. Kobayashi T, Hayashi A, Yoshikawa R, Okuda K, Hara K. The microbial flora from root canals and periodontal pockets of non-vital teeth associated
with advanced periodontitis. Int Endod J 1990;23:100-106.
5. Li H, Guan R, Sun J, Hou B. Bacteria community study of combined periodontal-endodontic lesions using denaturing gradient gel electrophoresis and
sequencing analysis. J Periodontol 2014;85:1442-1449.
6. Pereira CV, Stipp RN, Fonseca DC, Pereira LJ, Höfling JF. Detection and clonal analysis of anaerobic bacteria associated to endodontic-periodontal
lesions. J Periodontol 2011;82:1767-1775.
7. Rupf S, Kannengiesser S, Merte K, Pfister W, Sigusch B, Eschrich K. Comparison of profiles of key periodontal pathogens in periodontium and
endodontium. Endod Dent Traumatol 2000;16:269-275.
8. Asgary S, Fazlyab M. Management of failed periodontal surgical intervention for a furcal lesion with a nonsurgical endodontic approach. Restor
Dent Endod 2014;39:115-119.
9. Attam K, Tiwary R, Talwar S, Lamba AK. Palatogingival groove: endodontic-periodontal management--case report. J Endod 2010;36:1717-1720.
10. Ballal NV, Jothi V, Bhat KS, Bhat KM. Salvaging a tooth with a deep palatogingival groove: an endo-perio treatment--a case report. Int Endod J
2007;40:808-817.
11. Blanchard SB, Almasri A, Gray JL. Periodontal-endodontic lesion of a three-rooted maxillary premolar: report of a case. J Periodontol 2010;81:783-
788.
12. Castelo-Baz P, Ramos-Barbosa I, Martín-Biedma B, Dablanca-Blanco AB, Varela-Patiño P, Blanco-Carrión J. Combined Endodontic-Periodontal
Treatment of a Palatogingival Groove. J Endod 2015;41:1918-1922.
13. Coraini C. MT, De Palma C.M., Gobbato E.A., Costa R., De Micheli L., Castro D., Giunta C., Rossi S., Casto C. . Endodontic and periodontal treatment
of dens invaginatus: Report of 2 clinical cases. . G Ital Endod 2013;27 (2):86-94.
14. Floratos S.G. KSI. Surgical management of vertical root fractures for posterior teeth: Report of four cases. . J Endod 2012;38 (4):550-555.
15. Gandhi A, Kathuria A, Gandhi T. Endodontic-periodontal management of two rooted maxillary lateral incisor associated with complex radicular
lingual groove by using spiral computed tomography as a diagnostic aid: a case report. Int Endod J 2011;44:574-582.
16. Goyal L. Clinical effectiveness of combining platelet rich fibrin with alloplastic bone substitute for the management of combined endodontic
periodontal lesion. Restor Dent Endod 2014;39:51-55.
17. Kambale S, Aspalli N, Munavalli A, Ajgaonkar N, Babannavar R. A sequential approach in treatment of endo-perio lesion a case report. J Clin Diagn
Res 2014;8:ZD22-24.
18. Karabucak B. SFC. Conventional and Surgical Retreatment of Complex Periradicular Lesions With Periodontal Involvement. . J Endod 2009;35
(9):1310-1315.
19. Kerezoudis NP, Siskos GJ, Tsatsas V. Bilateral buccal radicular groove in maxillary incisors: case report. Int Endod J 2003;36:898-906.
20. Kishan KV, Hegde V, Ponnappa KC, Girish TN, Ponappa MC. Management of palato radicular groove in a maxillary lateral incisor. J Nat Sci Biol Med
2014;5:178-181.
21. Mali R, Lele P, Vishakha. Guided tissue regeneration in communicating periodontal and endodontic lesions - A hope for the hopeless! J Indian Soc
Periodontol 2011;15:410-413.
22. Miao H, Chen M, Otgonbayar T, et al. Papillary reconstruction and guided tissue regeneration for combined periodontal-endodontic lesions caused
by palatogingival groove and additional root: a case report. Clin Case Rep 2015;3:1042-1049.
23. Oh SL. Mesiobuccal root resection in endodontic-periodontal combined lesions. Int Endod J 2012;45:660-669.
24. Pickel C. Dysfunction prompts comprehensive oral health assessment. Compend Contin Educ Dent 2011;32:50-52, 54, 56-58.
25. Sharma S, Deepak P, Vivek S, Ranjan Dutta S. Palatogingival Groove: Recognizing and Managing the Hidden Tract in a Maxillary Incisor: A Case
Report. J Int Oral Health 2015;7:110-114.
26. Tobón-Arroyave SI, Domínguez-Mejía JS, Flórez-Moreno GA. Periosteal grafts as barriers in periradicular surgery: report of two cases. Int Endod J
2004;37:632-642.
27. White C, Bryant N. Combined therapy of mineral trioxide aggregate and guided tissue regeneration in the treatment of external root resorption and
an associated osseous defect. J Periodontol 2002;73:1517-1521.
28. Xia M, Qi Q. Bacterial analysis of combined periodontal-endodontic lesions by polymerase chain reaction-denaturing gradient gel electrophoresis. J
Oral Sci 2013;55:287-291.