Saving teeth with severe bone loss can be more effective than implants, landmark study finds
VIENNA: A groundbreaking 20-year clinical study has revealed that saving teeth with severe bone loss through periodontal regeneration (PR) may offer equal—or even greater—benefits than replacing them with dental implants or fixed bridges.
This new evidence, reported by the European Federation of Periodontology (EFP) and presented at EuroPerio11 in Vienna, is shifting the global dental narrative. The randomized trial tracked the long-term outcomes of 50 patients with advanced periodontitis, each with at least one tooth exhibiting bone loss to or beyond the root tip.
“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, Belgium, one of the lead researchers. “This study shows that regeneration is a powerful option that can give patients many more years with their own teeth.”
What the study found:
Half of the patients received periodontal regeneration (PR) to save their compromised tooth.
The other half had their tooth extracted and replaced with either a dental implant or a fixed dental bridge.
After two decades, the survival outcomes were surprisingly similar:
- Only four natural teeth were lost in the PR group.
- Just two implant failures occurred in the replacement group.
- Gum health remained stable across both groups.
- Treatment costs were significantly lower in the PR group.
This landmark data supports a growing shift toward tooth preservation strategies, particularly in cases where regeneration is feasible.
“Replacing a tooth is not necessarily better than saving it,” Dr. Cortellini explained. “If we can preserve the natural tooth, we delay extraction for many years—and that’s a win for both patients and health systems.”
Expertise and responsible decision-making matter
The researchers emphasized that patient selection and follow-up are crucial. Periodontal regeneration is not a one-size-fits-all solution and must be carefully considered on a case-by-case basis by a periodontist or oral health expert.
What this means for patients and dentists
This long-term evidence reinforces the importance of evaluating all treatment options before deciding on extraction. Saving a tooth with advanced periodontal disease is no longer an outdated hope—but an evidence-based, effective strategy when appropriate.
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