Influence of Endodontic Treatments on Periodontal Health: A Literature Review

Abstract

Abstract  

Introduction: Although the dental pulp and periodontium are distinct structures, they maintain an anatomical connection that allows for the bidirectional spread of infections. This interrelationship favors endo-periodontal lesions (EPLs), in which pulpal and periodontal infections mutually influence each other. The literature reports a higher prevalence of apical periodontitis in endodontically treated teeth, especially when deficiencies exist in the filling or crown restoration. Objective: To analyze the influence of endodontic treatments on periodontal health, addressing their anatomical and pathophysiological relationship, diagnosis, treatment, and prevention of EPLs. Materials and Methods: A qualitative and documentary literature review was conducted using PubMed, Scopus, Web of Science, SciELO, and Google Scholar, including articles published between 2015 and 2025 in English, Spanish, or Portuguese. Of the 55 studies identified, 14 were selected for critical analysis based on the inclusion and exclusion criteria. Results: The endodontic treatment technique is crucial for preventing apical periodontitis. The differential diagnosis of EPLs requires vitality tests, CBCT, and, in some cases, microbiological techniques. The combination of endodontic and periodontal therapy, complemented with platelet-rich fibrin, bone grafts, and mineral trioxide aggregate, enhances tissue regeneration, reduces inflammation, and improves prognosis. Conclusion: The successful management of EPLs requires comprehensive diagnosis, infection control, and interdisciplinary collaboration. The application of regenerative therapies and preventive strategies optimizes the preservation of dental and periodontal structures, contributing to predictable and sustainable clinical outcomes.