Treatment Alternatives Following Extraction of Teeth with Periodontal-Endodontic Lesions

Following extraction of tooth/teeth with advanced loss of periodontal support, as those with periodontal-endodontic lesions, the remaining bone architecture should be carefully evaluated, especially where implant-supported restoration is planned. Marked resorption of the residual alveolar bone is usually appreciated 3 months after tooth extraction. This process may impair implant-supported restoration outcome, especially in the upper jaw, where esthetics is a key factor. Different treatment alternatives are available at the time of tooth extraction, namely immediate implant placement, primary soft tissue closure of the extraction site that may be followed by early implant placement, ridge preservation, and ridge augmentation. For each clinical case, treatment possibilities should be considered and evaluated according to tooth location, esthetics, soft tissue characteristics, infection, number of implants simultaneously placed, available bone volume, bony defects, and treatment convenience.