Prevalence of Endodontic-Periodontal Lesions and Associated Risk Factors Among Patients Undergoing Orthodontic Treatment: A Retrospective Observational Study

Introduction: Endodontic-periodontal (endo-perio) lesions are complex pathological conditions involving simultaneous pulpal and periodontal tissue destruction, posing considerable diagnostic and therapeutic challenges.Although orthodontic treatment may influence periodontal health, limited evidence exists regarding the prevalence of endo-perio lesions and their associated risk factors among orthodontic patients.This study aimed to determine the prevalence of endo-perio lesions among patients undergoing orthodontic treatment and to identify demographic, clinical, and radiographic factors associated with their occurrence.Materials and methods: This retrospective observational study analyzed archived records of orthodontic patients.During the six-month record-review period, 1,250 orthodontic patient records were screened.Diagnosis was established using documented clinical findings, pulp vitality testing, and radiographic evaluation.Data were then analyzed, and continuous variables were compared using the independentsamples t test or Mann-Whitney U test, whereas categorical variables were compared using the chi-square test or Fisher's exact test.Independent predictors were identified using multivariable logistic regression.Statistical significance was established at p < 0.05.Results: The overall prevalence of endo-perio lesions was 5.76% (72/1,250).Patients with lesions were significantly older than those without lesions (33.7 ± 9.8 vs. 28.1 ± 9.0 years; p < 0.001) and had a longer median orthodontic treatment duration (27.0 vs. 24.0months; p = 0.009).Multivariable logistic regression identified that increasing age (adjusted OR = 1.04; 95% CI: 1.01-1.08;p = 0.012), molar teeth (adjusted OR = 2.87; 95% CI: 1.20-6.84;p = 0.017), non-vital pulp (adjusted OR = 52.90;95% CI: 20.72-135.10;p < 0.001), deep periodontal pockets ≥5 mm (adjusted OR = 92.14;95% CI: 21.80-389.50;p < 0.001), and radiographic bone loss (adjusted OR = 18.47; 95% CI: 5.46-62.52;p < 0.001) were independent predictors of endo-perio lesions.Conclusion: Older age, molar teeth, non-vital pulp, deep periodontal pockets, and radiographic bone loss were significant independent predictors of lesion occurrence.Comprehensive periodontal examination, pulp vitality testing, and radiographic assessment should be routinely integrated into orthodontic care to facilitate early diagnosis and interdisciplinary management.