The aim of the study was to discuss and evaluate the prognostic of natural teeth vs. dental implants in decision-making, as well as the treatment strategies applicable to periodontally-compromised patients.
Materials and method: 25 patients affected by aggressive periodontitis, with reserved prognostic for some teeth, were followed over a long period of time, the benefits and risks involved by treating periodontally-compromised dentures in association or not with implant’s insertion being carefully analyzed. The benefits and risks related by the cost-efficiency ratio of using implants for improving the prognosis for either the natural mobile tooth or the pillar tooth from partially-fixed prostheses are also discussed. Results and discussion: The present study suggests that the longitudinal loss of bone mass around the implants is correlated with previous experiments on periodontal bone loss, and also that the patients susceptible to periodontopathy are more exposed than those not in danger of developing peri-implantitis. Consequently, the natural teeth of the patient should be carefully considered when planning and performing a complex periodontal treatment, and also when the decision of keeping or extracting a tooth prior to implanting is taken.
Conclusions: An important aspect put into evidence in the study is the necessity of considering a strategical postponing of the implant (the optimum time for implant insertion) in a periodontally-susceptible patient, for a full utilization of the natural tooth and for extending and optimizing the longevity of dentition.
- implant prognosis
- periodontally compromised teeth
- tooth preservation