Management of the endodontic-periodontal lesion: a UK-based vignette survey of specialist clinicians

Aims The aim of this study was to evaluate and compare how specialist endodontists and periodontists in the UK manage endodontic-periodontal lesions (EPL) and the prognostic factors influencing their decision making, seeking to identify trends and areas for consensus. Methodology A cross-sectional vignette survey featuring four clinical cases was sent to GDC registered specialist endodontists and periodontists using social media platforms and advertisement by specialist societies. Results Fifty specialists (28 endodontists, 22 periodontists) completed the survey. Endodontists demonstrated greater confidence in managing periapical lesions, fractured teeth and other prosthodontic restorative considerations. However, they prescribed more periodontal regenerative surgery than periodontists. Periodontists were more confident in regenerative surgical approaches and emphasised oral hygiene with more case-dependant specificity. Periodontists were more aware of the benefit of endodontic treatment in vital teeth with bone loss to the apex. Periodontists were more likely to recommend extraction compared to endodontists. EPL were extracted at a higher rate than the evidence suggests is necessary. Conclusion The study highlights differences between specialties in diagnosing, managing, and prognosticating EPL, underscoring the value of multi-disciplinary collaboration and specialist care, particularly for grade 2 and 3 EPL.