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. 2025 May;17(Suppl 1):S615-S617.
doi: 10.4103/jpbs.jpbs_62_25. Epub 2025 May 10.

Nonsurgical vs. Surgical Treatment of Endo-Perio Lesions in Diabetic Patients: A 10-Year Retrospective Cohort Study

Anuj Singh Parihar  1 , Cauvery N Karbhari  2 , Shwetha Narayani  3 , Songbit Sinhababu  4 , Minerva Singh  5 , Rashmi Laddha  6
Affiliations

Nonsurgical vs. Surgical Treatment of Endo-Perio Lesions in Diabetic Patients: A 10-Year Retrospective Cohort Study

Anuj Singh Parihar et al. J Pharm Bioallied Sci. 2025 May.

Abstract

Background: Endo-perio lesions are challenging to manage in diabetic patients due to impaired healing and infection risk. This study compared long-term outcomes of nonsurgical and surgical treatments for these lesions.

Methods: We analyzed 187 diabetic patients with endo-perio lesions. 92 received nonsurgical treatment (root canal treatment ± scaling and root planing) and 95 underwent surgery (apicoectomy ± guided tissue regeneration). The primary outcome was tooth retention (Kaplan-Meier analysis). Secondary outcomes included lesion resolution, probing depth reduction, clinical attachment level gain, and patient-reported pain/discomfort.

Results: At 10 years, tooth retention was 82% (nonsurgical) and 75% (surgical) (P = 0.32). Both groups improved significantly (P < 0.05), but surgery yielded greater probing depth reduction and clinical attachment gain (P < 0.01). Surgical patients initially reported more discomfort, but pain levels were similar at 6 and 12 months.

Conclusions: Both approaches showed comparable long-term tooth retention. Surgical treatment enhanced periodontal healing but caused more initial discomfort.

Keywords: Diabetes mellitus; endo-perio lesion; nonsurgical treatment; surgical treatment; tooth retention.

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Conflict of interest statement

There are no conflicts of interest.

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