Microbiological Insights and Diagnostic Approaches in Endo-Perio Lesions

A BSTRACT Background: Endo-perio lesions are complex pathological conditions involving concurrent infections in endodontic and periodontal tissues. These lesions often present diagnostic and therapeutic challenges due to overlapping microbial etiologies and anatomical intercommunications. Aim: To investigate the microbiological composition and evaluate diagnostic methods for effective differentiation and management of endo-perio lesions. Methods: A cross-sectional study was conducted, enrolling 120 patients diagnosed with endo-perio lesions. Samples from root canals and periodontal pockets were analyzed using conventional culturing, polymerase chain reaction (PCR), and next-generation sequencing (NGS). Diagnostic tools such as radiographic imaging, clinical parameters, and microbial tests were assessed. Baseline and final data were statistically analyzed using paired t -tests and logistic regression models. Results: Microbial analysis revealed distinct profiles in primary endodontic ( F. nucleatum , P. endodontalis ), primary periodontal ( P. gingivalis , T. forsythia ), and combined lesions, with significant microbial diversity in the latter. PCR and NGS demonstrated higher diagnostic sensitivity (90%) and specificity (85%) compared with conventional methods. Statistical analysis showed significant differences in microbial abundance and diagnostic accuracy across lesion types ( P < 0.05). Conclusion: Endo-perio lesions exhibit unique microbial ecosystems that necessitate precise diagnostic approaches. Integration of advanced microbial diagnostics with clinical findings enhances lesion classification and treatment outcomes.