Dentaltown January 2020 - 69

practitioner's clinical judgment is important
to consider, particularly with regard to
teeth #12 and #13. While one clinician
may recommend extraction and prosthetic
replacement, another may recommend
regenerative periodontal therapy.
In addition, the distinction must be
made between tooth loss due to periodontitis
and treatment plan-based tooth loss. For
this discussion, the treatment plan for the
patient's mandibular incisor region can
be highlighted. While teeth #24 and #25
were deemed periodontally hopeless due to

the extent of bone loss and tooth mobility,
teeth #23 and #26 were not considered
periodontally hopeless. Considering the
prosthetic treatment plan, options may
include the following: a single implant with
a cantilevered crown at the #24-25 site; a
tooth-supported FPD utilizing teeth #23 and
#26 as abutments; and extraction of teeth
#23 and #26 (in addition to extraction of
teeth #24 and #25) with placement of an
implant-supported fixed partial denture with
implants at sites #23 and #26. It is critical
to note that extraction of teeth #23-26

should be considered tooth loss due not to
periodontitis, but to extraction as a means
of facilitating prosthetic treatment. In other
words, this was a matter of "treatment
plan-based tooth loss."
It is also important to stress that the
updated classification system is meant
to supplement, rather than replace, the
clinician's judgment, experience and skill.
The judgment of the clinician is particularly
crucial in taking into account such factors
as the patient's commitment to compliance
and anticipated response to treatment.

Fig. 12: Periapical radiograph demonstrates the
narrow, tapered root form of teeth #12 and 13,
along with severe alveolar bone loss.

Fig. 11: Periapical radiograph demonstrates bone
loss to the apex of tooth #24.

Fig. 10: Full-mouth radiographic series
demonstrates generalized alveolar bone loss
extending to and beyond the mid-third of the
root; vertical bone loss is evident at several sites.

dentaltown.com \\ JANUARY 2020

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Dentaltown January 2020

Table of Contents for the Digital Edition of Dentaltown January 2020

Dentaltown January 2020 - Intro
Dentaltown January 2020 - Cover1
Dentaltown January 2020 - Cover2
Dentaltown January 2020 - 1
Dentaltown January 2020 - 2
Dentaltown January 2020 - 3
Dentaltown January 2020 - 4
Dentaltown January 2020 - 5
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