Retention of hopeless teeth: the effect on the adjacent proximal bone following periodontal surgery.
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 > or =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).


CONCLUSIONS
Long-term preservation of hopeless teeth following periodontal surgery is an attainable goal with no detrimental effect on the adjacent proximal teeth.
Machtei
Eli E
EE
Unit of Periodontology, Department of Oral and Dental Medicine, Rambam Health Care Campus, Haifa, Israel. machtei@rambam.health.gov.il
Hirsch
Ilan
I
D000293:Adolescent; D000328:Adult; D000368:Aged; D016301:Alveolar Bone Loss / Q000000981:diagnostic imaging / Q000601:surgery*; D024201:Bystander Effect; D012534:Dental Scaling; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010518:Periodontitis / Q000601:surgery*; D019252:Radiography, Dental, Digital; D012189:Retrospective Studies; D014081:Tooth Extraction