Bone loss of relevance for implant placement in periodontitis patients

T reatment of patients with severe periodontal disease often involves complicated decisions concerning disease activity and prognosis of teeth with extensive attachment loss. Many factors, in addition to the periodontal status, contribute to the definitive treatment plan. The decision to extract or retain severely periodontally involved teeth is based on a combination of evaluating the disease activity, the prognosis, and the restorative possibilities of these teeth. The use of osseointegrated dental implants is a well documented and predictable method for treating edentulous or partially edentulous patients [1–7]. The possibility of an implant-anchored fixed bridge or an overdenture prosthesis has greatly improved the restorative alternatives in edentulous or partially edentulous patients. Even in patients treated for periodontal disease, restorative treatment with osseointegrated implants has been shown to be successful and predictable [8]. In some periodontal patients not responding to conventional periodontal therapy, the treatment scenario may also include a strategy of preserving alveolar bone of sufficient quality and volume for future implant placement.