Retention of "Hopeless" teeth following surgery: Effect on alveolar height

Retention of teeth diagnosed as periodontally "Hopeless" may accelerate the destruction in the adjacent periodontium. PURPOSE: to examine the effect of retention of "hopeless" teeth on bone loss of adjacent proximal teeth following periodontal surgery. METHODS: 54 teeth from 38 patients were included in this retrospective study, provided that they had follow- up radiographs ≥24 months since surgery. Teeth were considered "Hopeless" if they had ≥70% bone loss at either proximal sites. All patients completed periodontal therapy including SRP and periodontal surgery at these sites. Cases were grouped into: "Retained" where the hopeless teeth were maintained at the time of the surgery and thereafter, and "Extracted" where the hopeless teeth were removed at the time of the surgery. All radiographs were digitized and measurements of linear distances were preformed using a computerized program. Measurements were made from the root apex to the CEJ and to alveolar crest. Bone loss was defined as the difference between those two figures. RESULTS: Patients were followed from 2-10 years (mean=4.16±2.14). Mean Radiographic Bone Gain (RBG) was 0.41±0.49 mm. These changes ranged between 6.05 mm bone gain to 7.38 mm bone loss. Annual bone gain was 0.21±0.18 mm . Similarly, teeth adjacent to the hopeless tooth had RBG of 0.61±0.48 mm and 0.22±0.51 mm for the distal and mesial proximal sites respectively. RBG was greater in the distal proximal teeth of the extracted (2.52±0.93 mm) compared with the retained group (0.15±0.52 mm) p=0.0532 . Similarly, mesial RBG was greater in the extracted group (0.92±0.55 mm) compared to the retained group (0.22±0.51 mm). However, this difference didn't reach statistical significance. CONCLUSION: Long term preservation of "hopeless" teeth following periodontal surgery is an attainable goal with no detrimental effect on the neighboring teeth.