Endodontic–Periodontal Lesions: A Cross-Sectional Study Assessing Knowledge and Diagnostic Proficiency among Senior Undergraduate Dental Students at Qassim University

Abstract

Objective: To assess the knowledge and diagnostic proficiency of senior undergraduate dental students regarding endodontic–periodontal lesions (EPLs) at the College of Dentistry, Qassim University.

Study Design: Cross-sectional study
Place and Duration of Study: This study was conducted at the College of Dentistry, Qassim University, Saudi Arabia, September-October 2025.

Methods: A structured 17-item survey was distributed to the 4th - and 5th
-year Bachelor of Dental Surgery (BDS) students. Fourteen items assessed knowledge (classification, routes of communication, diagnostic tests, prognosis, microbiology, and treatment principles), and three case-based scenarios assessed diagnostic proficiency. Data were analyzed using SPSS Version 25. Differences between academic years were evaluated using the chi-square test. Binary logistic regression was performed for case-based scenarios to estimate odds ratios (OR) with 95% confidence intervals (CI). A p-value <0.05 was considered statistically significant.

Results: 54 students participated (4th -year: 28 [51.9%]; 5th -year: 26 [48.1%]). 5th -year students achieved higher correct responses than 4th -year students for key knowledge items. Significant differences were observed in recognition of dentinal tubule exposure as a communication pathway (81.3% vs 46.4%; p=0.020) and extraction preference in periodontal-origin combined lesions (87.3% vs 53.2%; p=0.012). Logistic regression showed that 5thyear students had higher odds of correctly diagnosing an endodontic–periodontal lesion (OR=4.05; 95% CI: 1.30– 12.62; p=0.016) and a periodontal–endodontic lesion (OR=3.33; 95% CI: 1.03–10.80; p=0.044). No significant difference was observed for the true combined lesion (p=0.530).

Conclusion: Senior undergraduate dental students demonstrated moderate knowledge and variable diagnostic proficiency regarding EPLs, with significantly better performance among 5th-year students in selected domains. Enhanced case-based teaching and structured clinical exposure are recommended.