A significant long-term research offered at EuroPerio11, the world’s main congress on gum well being and implant dentistry by the European Federation of Periodontology (EFP), reveals that saving tooth with extreme bone loss by periodontal regeneration (PR) presents advantages equal to – if not higher than – changing them with dental implants or bridges.
The research adopted sufferers for 20 years, evaluating those that underwent superior regenerative procedures to maintain a tooth, with those that had the identical tooth extracted and changed with both an implant or a set bridge. The findings are clear: saving the tooth can work simply as effectively, prices much less in the long run, and should provide a greater expertise for some sufferers.
The concept that a tooth with extreme lack of bone should all the time be eliminated is not essentially true. This research exhibits that regeneration is a robust choice that may give sufferers many extra years with their very own tooth.”
Physician Simone Cortellini from KU Leuven in Belgium, and one of many lead investigators
In instances of extreme gum illness (periodontitis), the tissues that help the tooth, together with the bone, can deteriorate, typically all the best way all the way down to the basis tip (apex). Historically, these tooth are thought-about “hopeless” and sometimes eliminated. However periodontal regeneration makes use of surgical methods and supplies to rebuild misplaced bone and tissue, doubtlessly saving the tooth.
“We wished to push the boundaries of what is thought-about ‘hopeless’,” stated Dr Cortellini. “Our objective was to indicate that, in the proper sufferers, even tooth with very superior harm might be efficiently handled and saved.”
The randomised managed trial concerned 50 sufferers with extreme periodontitis (Stage III or IV). Every had not less than one tooth with attachment loss extending to or past the apex, an indication of utmost tissue destruction. Individuals had been divided into two teams:
- PR group: acquired periodontal regeneration to attempt to save the tooth
- TER group: had the tooth extracted and changed with both an implant or a set bridge
Key findings after 20 years
After 20 years, each remedy choices, saving the pure tooth or changing it with an implant, proved to achieve success. Solely 4 tooth had been misplaced within the group that saved their pure tooth, whereas simply two implants failed within the alternative group. Gum well being remained secure over time in sufferers who saved their tooth, with wholesome attachment ranges maintained twenty years after remedy.
When it got here to price, conserving the pure tooth turned out to be considerably inexpensive in the long term, even when factoring in ongoing care and upkeep. Importantly, each teams had related outcomes when it comes to issues and remedy success.
“Changing a tooth just isn’t essentially higher than saving it,” defined Cortellini. “In each instances, there’s an opportunity of issues over time, particularly in sufferers with a historical past of gum illness. But when we are able to save the tooth, we delay extraction for a few years and that is a win for sufferers and for dental care programs.”
Regenerative procedures aren’t solely inexpensive upfront, however this research additionally confirmed that over 20 years, they nonetheless price considerably lower than implants or bridges, largely as a result of saved tooth usually require fewer long-term repairs. “Even after twenty years, periodontal regeneration nonetheless got here out as cheaper,” famous Cortellini.
Is regeneration proper for everybody?
Regeneration is a posh method that is not appropriate for each affected person or each tooth. It really works greatest in sufferers who’re in good common well being, don’t smoke, are extremely motivated and preserve glorious oral hygiene
“You might be the very best periodontist on this planet, but when the affected person is not candidate, you may battle to get long-term success,” stated Cortellini. “Affected person choice, follow-up care and affected person compliance are key.”
“This landmark research reinforces that in the proper fingers and with the proper sufferers, saving even severely broken tooth by regeneration might be simply as efficient -if no more so – than changing them,” stated Lior Shapira, EuroPerio11 scientific chair. “It is not solely a clinically sound choice, but additionally one that may result in significant long-term financial savings for sufferers. Whereas we did see the fee hole slender barely over time, preserving the pure tooth remained cheaper general. On the similar time, it is essential to acknowledge that regeneration is not a one-size-fits-all resolution. Continued innovation in biomaterials can even assist lengthen the advantages of regeneration to extra sufferers.”
“A very powerful message is easy: save the tooth in the event you can!” concluded Cortellini. “Tooth alternative is an efficient choice, however regeneration can provide many years of stability and let individuals preserve their very own tooth. Our analysis tells us to assume twice earlier than extracting a tooth. If it had been your tooth, would not you need to attempt to preserve it first?”
