The effect of endodontic treatment using different intracanal medicaments on periodontal attachment level in concurrent endodontic-periodontal lesions: A randomized controlled trial.

Aim: The aim of this study is to evaluate the effect of different intracanal medicaments used during endodontic treatment on periodontal attachment level in concurrent endodontic-periodontal lesions without communication.

Materials and Methods: Seventy-five teeth with combined endodontic-periodontal lesions were randomly assigned to 3 groups: Test Group I (calcium hydroxide [Ca(OH)2 ]), Test Group II (2% chlorhexidine + Ca(OH)2 ), and control group (no intracanal medicament). Root canal treatment (RCT) was performed using standard methodology. Teeth of test groups were medicated with respective medicaments for 10 days before obturation. Scaling and root planning was done 1 month after completion of RCT in all the groups. Clinical measurements, including probing depth (PD), clinical attachment level (CAL), and bleeding on probing (BOP) were recorded at baseline, 1, 3, and 6 months. Radiographic parameters, including periapical index (PAI) score and alveolar bone level, were measured at baseline and 6 months.

Statistical Analysis: Data were analyzed using Friedman test, Kruskal-Wallis, and Wilcoxon signed-rank test.

Results: Significant improvement in PD, CAL, %BOP, and PAI score ( P < 0.05) was found in all the three groups from baseline to 6 months. However, there was no significant intergroup difference. No significant difference was observed from baseline to 6 months in marginal bone level within the three groups.

Conclusion: Endodontic treatment before periodontal therapy results in attachment gain. Intracanal medicaments may not affect the healing of concurrent endodontic-periodontal lesions without communication.