Resumen de Retention of Hopeless Teeth: The Effect on the Adjacent Proximal Bone Following Periodontal Surgery
Retention of Hopeless Teeth: The Effect on the Adjacent Proximal Bone Following Periodontal Surgery Eli E. Machtei*† and Ilan Hirsch* *Unit of Periodontology, Department of Oral and Dental Medicine, Rambam Health Care Campus, Haifa, Israel.
†Faculty of Medicine, Technion, Haifa, Israel.
Correspondence: Dr. Eli E. Machtei, Department of Oral and Dental Medicine and Unit of Periodontology, Rambam Health Care Campus, P.O. Box 9602, Haifa 31096, Israel. Fax: 972-4-854-3057; e-mail: machtei@rambam.health.gov.il.
Background: Clinical wisdom often suggests that retention of periodontally hopeless teeth may accelerate the destruction of the adjacent periodontium. The purpose of this study was to examine the effect of retaining hopeless teeth on the adjacent alveolar bone following periodontal surgery.
Methods: A retrospective study was conducted based on intraoral radiographs. Teeth were considered hopeless if they had lost ≥70% bone height at either of the proximal surfaces. The minimal follow-up period after surgery was 24 months. All subjects completed periodontal therapy, including scaling and root planing (SRP), and periodontal surgery at these sites. Ninety-three subjects with 110 hopeless teeth were included in this study. Cases were sorted into two groups: retained, which included 57 hopeless teeth (50 subjects) that were maintained; and extracted, which included 53 hopeless teeth (43 subjects) that were removed at surgery. All radiographs were digitized, and measurements of radiographic bone distance (RBD) were made using computerized software.
Results: Mean follow-up was 4.40 ± 0.23 years. For the retained hopeless teeth, there was a mean bone gain of 0.82 mm from baseline (7.18 ± 0.35 mm) to the final examination (6.45 ± 0.41 mm; P = 0.0061). Likewise, the postoperative percentage of RBD of the retained hopeless teeth showed a statistically significant improvement from baseline (57.46% ± 1.5%) to the final examination (52.32% ± 2.03%; P = 0.0032). Teeth adjacent to a hopeless tooth had a slight radiographic bone gain postoperatively, which was greater in the extracted group. However, it was significant only for the distal neighboring teeth (1.50% versus 11.36%, respectively; P = 0.0119).
Conclusion: Long-term preservation of hopeless teeth following periodontal surgery is an attainable goal with no detrimental effect on the adjacent proximal teeth.
KEYWORDS: Bone loss, periodontitis, retention, surgery Cited by Wim Teughels, Rutger Dhondt, Christel Dekeyser and Marc Quirynen. (2014) Treatment of aggressive periodontitis. Periodontology 2000 65:10.1111/prd.2014.65.issue-1, 107-133.
Online publication date: 1-Jun-2014.
CrossRef Christian Graetz, Falk Schwendicke, Maren Kahl, Christof E. Dörfer, Sonja Sälzer, Claudia Springer, Svenja Schützhold, Thomas Kocher, Jörgen König and Andreas Rühling. (2013) Prosthetic rehabilitation of patients with history of moderate to severe periodontitis: a long-term evaluation. Journal of Clinical Periodontology 40:10.1111/jcpe.2013.40.issue-8, 799-806.
Online publication date: 1-Aug-2013.
CrossRef Vibeke Baelum and Rodrigo López. (2013) Periodontal disease epidemiology - learned and unlearned?. Periodontology 2000 62:10.1111/prd.2013.62.issue-1, 37-58.
Online publication date: 1-Jun-2013.
CrossRef Clarice Field, Qing Li, Wei Li, Mark Thompson and Michael Swain. (2012) A comparative mechanical and bone remodelling study of all-ceramic posterior inlay and onlay fixed partial dentures. Journal of Dentistry 40, 48-56.
Online publication date: 1-Jan-2012.
CrossRef Vibeke Baelum. (2011) Dentistry and population approaches for preventing dental diseases. Journal of Dentistry 39, S9-S19.
Online publication date: 1-Dec-2011.
CrossRef P.R. Schmidlin. (2011) Sekundäreffekte der Parodontaltherapie. wissen kompakt 5, 13-21.
Online publication date: 1-Nov-2011.
CrossRef Christian Graetz, Christof E. Dörfer, Maren Kahl, Thomas Kocher, Karim Fawzy El-Sayed, Jan-Frederik Wiebe, Konstantin Gomer and Andreas Rühling. (2011) Retention of questionable and hopeless teeth in compliant patients treated for aggressive periodontitis. Journal of Clinical Periodontology, no-no.
Online publication date: 1-May-2011.
CrossRef Pierpaolo Cortellini, Gabrielle Stalpers, Aniello Mollo and Maurizio S. Tonetti. (2011) Periodontal regeneration versus extraction and prosthetic replacement of teeth severely compromised by attachment loss to the apex: 5-year results of an ongoing randomized clinical trial : Regeneration and hopeless teeth. Journal Of Clinical Periodontology 38:10, 915.
CrossRef Marwan Abou Rass. (2010) Interim Endodontic Therapy for Alveolar Socket Bone Regeneration of Infected Hopeless Teeth Prior to Implant Therapy. Journal of Oral Implantology 36, 37-59.
Online publication date: 1-Jan-2010.
CrossRef Daisuke Ekuni, Tatsuo Yamamoto and Noriko Takeuchi. (2009) Retrospective study of teeth with a poor prognosis following non-surgical periodontal treatment. Journal of Clinical Periodontology 36:10.1111/cpe.2009.36.issue-4, 343-348.
Online publication date: 1-Apr-2009.
CrossRef (2008) Retention of hopeless teeth: the effect on the adjacent proximal bone following periodontal surgery. BDJ 205, 27-27.
Online publication date: 12-Jul-2008.
