Saving teeth with severe bone loss through periodontal regeneration (PR) offers benefits equal to — or greater than — replacing them with dental implants or bridges, according to a study that tracked patients for two decades, the European Federation of Periodontology (EFP) reported.
“The idea that a tooth with severe loss of bone must always be removed isn’t necessarily true,” said Dr. Simone Cortellini of KU Leuven in Belgium, one of the lead investigators. “This study shows that regeneration is a powerful option that can give patients many more years with their own teeth.”
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The randomized trial, presented at EuroPerio11 in Vienna, followed 50 patients with advanced periodontitis. Each had at least one tooth with attachment loss reaching or exceeding the root tip. Half the group received PR treatment to save the tooth, while the other half had the tooth extracted and replaced with a dental implant or fixed bridge.
After 20 years, both approaches proved effective. Just four teeth were lost in the PR group, compared to two implant failures in the replacement group. Gum health remained stable and treatment costs were lower in the regeneration group.
“Replacing a tooth is not necessarily better than saving it,” Cortellini said. “If we can preserve the natural tooth, we delay extraction for many years — and that’s a win for patients and dental care systems.”
The study emphasizes careful patient selection and follow-up, noting that regeneration isn’t suitable for everyone.
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