PERIO - Periodontal Practice Today
PERIO - Periodontal Practice Today 5 (2008), No. 4     4. June 2009
PERIO - Periodontal Practice Today 1 (2004), No. 2  (07.07.2004)

Page 131-142

Treatment Strategies in the Case of Advanced Attachment Loss.
Part I: The Conservation of Strategically Important Teeth in Order to Avoid Dental Restorations
Rühling, Andreas
In adopting a treatment strategy with the objective of conserving strategically important teeth with advanced attachment loss in order to avoid possible complications in the case of prosthetic restoration, all clinically relevant therapeutic possibilities should be utilized. The main focus is on the treatment of teeth with horizontal bone loss down to the apical third of the root with deep, often only one-sided vertical bone defects , through-and-through furcations with considerable defect height, as well as combined periodontal and endodontic inflammations. This article describes cases which show that it is possible to conserve critical teeth over many years without progressive bone loss, but that complications may endanger its long-term success due to endodontic factors, furcation caries, and root fractures. Hence, the implementation of this treatment strategy demands an active conservation therapy in order to control these complications. The successful periodontal treatment of an advanced, generalized, chronic periodontitis is illustrated, discussed, and documented over a period of 13 years by means of a specific patient case example.

Keywords: treatment strategy, periodontitis, bone loss, critical teeth, dental restorations