Revista de Odontologia da UNESP
https://revodontolunesp.com.br/article/doi/10.1590/1807-2577.20250024
Revista de Odontologia da UNESP
Artigo Original

Exploratory analysis of predictive factors for radiographic repair of endo-periodontal lesions: a pilot study

Análise exploratória de fatores preditivos para o reparo radiográfico de lesões endoperiodontais: um estudo piloto

Hisadora Fernandes Carvalho LOPES; Laura Morais AFFONSO; Gabrielly Caruso CATALANO; Fernanda Ferrari Esteves TORRES; Thamiris CIRELLI

http://dx.doi.org/10.1590/1807-2577.20250024 Rev. odontol. UNESP, vol.55, e20250024, 2026
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Abstract

Introduction: Endo-periodontal lesions (EPLs) are complex conditions with simultaneous endodontic and periodontal infections.

Objective: This study aimed to evaluate factors associated with the radiographic repair of EPLs, with a particular focus on clinical, periodontal, and systemic variables, using a decision tree analysis to identify the most influential factors.

Material and method: This retrospective study analyzed records of patients treated for EPLs at UNIFAE (2022-2023), who received combined endodontic-periodontal therapy and were reassessed at least six months post-treatment. Clinical, demographic, and radiographic data were collected, including probing depth (PD), bleeding on probing (BOP), diabetes status, age, and follow-up duration. Patients were classified into two categories based on radiographic and clinical criteria: complete repair or partial repair. Statistical analyses included chi-square and t-tests, complemented by a decision tree model (CART algorithm) to identify the primary predictors of radiographic repair.

Result: The study initially included 16 patients (18 teeth), but follow-up was completed with only seven patients (seven teeth), with longer follow-up linked to complete radiographic repair. The decision tree analysis confirmed follow-up time as the strongest predictor, followed by diabetes and PD. Patients with diabetes exhibited a higher likelihood of partial repair. Although bivariate analyses did not demonstrate statistical differences, the exploratory model highlighted the potential hierarchy of these variables.

Conclusion: These findings suggest the importance of prolonged follow-up and systemic health, especially diabetes, in the prognosis of EPL treatment, emphasizing the need for individualized monitoring and integrated endodontic-periodontal care. However, these findings should be interpreted with caution due to the limited sample size. Further large-scale, prospective studies are needed to confirm these predictors.

Keywords

Endodontics; periodontics; diabetes mellitus; wound healing; decision trees

Resumo

Introduction: Endo-periodontal lesions (EPLs) are complex conditions with simultaneous endodontic and periodontal infections.

Objective: This study aimed to evaluate factors associated with the radiographic repair of EPLs, with a particular focus on clinical, periodontal, and systemic variables, using a decision tree analysis to identify the most influential factors.

Material and method: This retrospective study analyzed records of patients treated for EPLs at UNIFAE (2022-2023), who received combined endodontic-periodontal therapy and were reassessed at least six months post-treatment. Clinical, demographic, and radiographic data were collected, including probing depth (PD), bleeding on probing (BOP), diabetes status, age, and follow-up duration. Patients were classified into two categories based on radiographic and clinical criteria: complete repair or partial repair. Statistical analyses included chi-square and t-tests, complemented by a decision tree model (CART algorithm) to identify the primary predictors of radiographic repair.

Result: The study initially included 16 patients (18 teeth), but follow-up was completed with only seven patients (seven teeth), with longer follow-up linked to complete radiographic repair. The decision tree analysis confirmed follow-up time as the strongest predictor, followed by diabetes and PD. Patients with diabetes exhibited a higher likelihood of partial repair. Although bivariate analyses did not demonstrate statistical differences, the exploratory model highlighted the potential hierarchy of these variables.

Conclusion: These findings suggest the importance of prolonged follow-up and systemic health, especially diabetes, in the prognosis of EPL treatment, emphasizing the need for individualized monitoring and integrated endodontic-periodontal care. However, these findings should be interpreted with caution due to the limited sample size. Further large-scale, prospective studies are needed to confirm these predictors.

Introdução: A lesão Endo-periodontal (LEP) são condições infecciosas complexas e simultâneas.

Objetivo: Este estudo teve como objetivo avaliar os fatores associados à reparação radiográfica de lesões endoperiodontais (LEPs), com foco particular em variáveis clínicas, periodontais e sistêmicas, utilizando uma análise de árvore de decisão para identificar os fatores mais influentes.

Material e método: Este estudo retrospectivo analisou os prontuários de pacientes tratados para LEPs na UNIFAE (2022-2023), que receberam terapia endodôntico-periodontal combinada e foram reavaliados pelo menos seis meses após o tratamento. Foram coletados dados clínicos, demográficos e radiográficos, incluindo profundidade de sondagem (PS), sangramento à sondagem (SS), presença de diabetes, idade e duração do acompanhamento. Os pacientes foram classificados em duas categorias com base em critérios radiográficos e clínicos: reparação completa ou reparação parcial. As análises estatísticas incluíram testes qui-quadrado e t de Student, complementados por um modelo de árvore de decisão (algoritmo CART) para identificar os principais preditores de reparação radiográfica.

Resultado: O estudo incluiu inicialmente 16 pacientes (18 dentes), mas o acompanhamento foi concluído com apenas sete pacientes (sete dentes), sendo que um acompanhamento mais longo esteve associado à reparação radiográfica completa. A análise de árvore de decisão confirmou o tempo de acompanhamento como o preditor mais forte, seguido por diabetes e doença periodontal. Pacientes com diabetes apresentaram maior probabilidade de reparo parcial. Embora as análises bivariadas não tenham demonstrado diferenças estatísticas, o modelo exploratório destacou a hierarquia potencial dessas variáveis.

Conclusão: Esses achados sugerem a importância do acompanhamento prolongado e da saúde sistêmica, especialmente o diabetes, no prognóstico do tratamento da periodontite exsudativa, enfatizando a necessidade de monitoramento individualizado e cuidado endodôntico-periodontal integrado. No entanto, esses achados devem ser interpretados com cautela devido ao tamanho limitado da amostra. Estudos prospectivos de grande escala são necessários para confirmar esses preditores.

Palavras-chave

Endodontia; periodontia; diabetes mellitus; cicatrização; árvores de decisão

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01/08/2025

Aceito em:
16/03/2026

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