SynthesisInternational dental journal2026
Effects of Different Treatment Sequences on the Efficacy of Combined Periodontal-Endodontic Lesions: A Systematic Review and Meta-Analysis.
Synthesis in International dental journal, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
2 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Cranial Base Characteristics in Growing Patients With Class III Skeletal Pattern: A Systematic Review and Meta-Analysis.International dental journal · 2026Pooled it
- From Caries to Periodontal Breakdown: A Biological and Clinical Continuum Linking Cariology, Operative Dentistry, Endodontics, and Periodontology.Dentistry journal · 2026Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
13 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveThis study aimed to evaluate systematically the clinical efficacy of different treatment sequences (root canal therapy first, periodontal therapy first or periodontal therapy only) in periodontal-endodontic lesions (PELs; also termed EPL in some literature).
methodsComprehensive searches were conducted in English databases (MEDLINE, Embase, Cochrane Central Register of Controlled Trials, Web of Science, Scopus), Chinese databases (Chinese National Knowledge Infrastructure, Wanfang, Weipu) and grey literature sources from inception to May 2025. Studies were included in randomised controlled trials (RCTs), non-randomised controlled studies (nRCTs) and comparative observational studies that reported the probing depth (PD), clinical attachment level (CAL) and tooth survival/success rate in adult patients with PELs.
resultsA total of 16 studies (10 RCTs, 6 non-RCTs, with a total of 1468 cases) were included. Meta-analysis showed that root canal treatment-first treatment could significantly improve PD shortening rate (pooled mean difference [MD] = -1.07 mm; 95% CI: -1.49 to -0.65; P < .0001), CAL gain (MD = 0.99 mm; 95% CI: 0.61-1.37; P < .0001) and tooth survival/success rate (risk ratio = 1.22; 95% CI: 1.08-1.37; P = .001). The results showed significant heterogeneity (PD: I
conclusionThe endodontic-first approach significantly improved the clinical outcomes of combined PELs compared with periodontal-first or periodontal-only treatment. However, significant heterogeneity across lesion categories and interventions, together with evidence of publication bias, highlights the need for cautious interpretation and underscores the importance of future well-designed, standardised RCTs.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.