Niazi, SadiaAlfuraih, Norah2024-10-162024https://hdl.handle.net/20.500.14154/73255Aims: 1- To evaluate the accuracy between the clinical and radiographic assessment using PA and CBCT scan of endodontic-periodontal lesions (EPLs). 2- To characterize the clinical and radiographic findings of grade 1, 2 and 3 of EPL without root as per Herrera et al., (2017) EPL Classification. 3- Based on the clinical and radiographic assessment determine the treatment planning of Grade 1, 2 and 3 EPL. Methodology: The service evaluation was carried out for the patients referred from the periodontal new patient consultant clinic and assessed in the Endodontic-Periodontics clinic at Guy’s Hospital, Guy’s and St Thomas NHS Foundation Trust. This service evaluation was carried out between March 2022- November 2023. All the information obtained were anonymized and transferred to an Excel spreadsheet. Data collected were analyzed using IBM SPSS. Chi2 test is used to compare the homogeneity of proportions of categories of care planning through levels of a second variable. Kruskal-Wallis test was used to compare distributions of an ordinal variable through different treatment options. Spearman´s correlation was used to assess the non-linear association between variables. Paired t-test was used to compare means of measurements taken with two techniques or methods in the same tooth (or root). Linearly weighted kappa´s index was used to assess the level of concordance between two parallel ordinal classifications. McNemar´s test was used to investigate about a preferent direction of discrepancies. Results: A total of 61 teeth with EPL were examined to establish the optimal care planning. 30 out of 61 teeth were 1st molars (49.2%). 100% of the patients had periodontitis, in which 75% had generalized periodontitis. 72% of the teeth were 4 diagnosed with EPL Grade 3. 63.3% of the teeth diagnosed with EPL grade 3 had bone loss extended beyond the apical third. 38.7% showed an extensive circumferential bone loss exceeding 270. Extraction and root canal treatment (RCT) followed by non-surgical periodontal therapy were the two most prevalent therapeutic approaches, accounting for approximately 69% of all cases. However, in some cases where RCT and NSPT intervention were initially implemented, subsequent periodontal re-assessment revealed persistent pocketing, prompting the surgical periodontal intervention. Conclusion: The new EPL classification by Herrera (2018) provides limited information required for care-planning of these complex cases, whereas additional radiographic classification using CBCT scan is helpful in more defined care planning for such cases.56enEPLEndo-periodontal lesionsroot canal treatmentCBCTCare planningService evaluation of care planning of Endodontic-Periodontal lesion (EPL) without root damage based on clinical and radiographic findings and the outcome of the care planningThesis