{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,6]],"date-time":"2026-09-06T17:20:38Z","timestamp":1788715238155,"version":"build-2803163510"},"reference-count":72,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,10,29]],"date-time":"2025-10-29T00:00:00Z","timestamp":1761696000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,10,29]],"date-time":"2025-10-29T00:00:00Z","timestamp":1761696000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["aap.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Periodontology"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Direct comparative data on periodontal regeneration (PR) versus extraction and implant placement remain limited. Tooth\u2010specific periodontal conditions such as furcation involvement and overall tooth prognosis may dictate success or failure of such treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective analysis was conducted on patients undergoing periodontal regenerative procedures or dental implants at the University of Michigan periodontics clinics. Clinical outcomes were assessed, including tooth and implant survival, success rates, and complications. Cost\u2010effectiveness was evaluated using the incremental cost\u2010effectiveness ratio (ICER).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In a cohort of 130 subjects (176 sites; 88 PR\u2010treated teeth and 88 implants; mean age 63.7\u00a0\u00a0\u00b1\u00a0\u00a012.7 years) followed for 6.4 years on average, no differences in survival or success rates were found (odds ratio [OR]\u00a0\u00a0=\u00a0\u00a00.36,\n                      <jats:italic>p\u00a0<\/jats:italic>\n                      \u00a0=\u00a0\u00a00.2, and OR\u00a0=\u00a00.77,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.56, respectively). In the PR group, a one\u2010wall defect and \u22651 furcation involvement (FI) increased the risk of tooth loss by approximately fourfold, while Periodontal Risk Scores (PRSs) of 2 and 3 were associated with 22\u2010 to 35\u2010fold greater risk than PRS1 (\n                      <jats:italic>p\u00a0<\/jats:italic>\n                      \u00a0&lt;\u00a0\u00a00.05). \u201cThe total complication rate in the implant group was 26.1%, largely due to peri\u2010implantitis (PI), compared to 9.1% in the PR group (OR\u00a0=\u00a03.54,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.006).\u201d Kaplan\u2013Meier analysis revealed mean survival times of 9.3 years for PR and 12.65 years for implants. Implant cost\u2010effectiveness depended on initial tooth prognosis and FI, with a 60% reduction in ICER per additional year ($187) compared to teeth with a good prognosis (PRS1).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Both PR and dental implant treatments achieved comparable long\u2010term survival and success rates. Cost considerations suggest personalized treatment decisions based on individual periodontal conditions like FI and overall tooth prognosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Plain language summary<\/jats:title>\n                    <jats:p>This study compared the long\u2010term outcomes and cost\u2010effectiveness of 2 approaches\u2014periodontal regeneration to preserve teeth versus dental implants to replace them\u2014in patients with advanced periodontitis. The analysis found that both treatments generally achieved similar survival and success rates. However, implants tended to have more complications, especially due to peri\u2010implantitis, while teeth with certain conditions, like molars with advanced furcation involvement or higher periodontal risk scores, were more likely to be lost over time. Although no clear cost\u2010effectiveness advantage emerged for either approach, the findings emphasize that initial tooth health and other specific conditions significantly influence outcomes. Therefore, personalized treatment decisions considering the patient's unique periodontal situation may help improve both clinical results and cost efficiency.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jper.70023","type":"journal-article","created":{"date-parts":[[2025,10,29]],"date-time":"2025-10-29T18:46:06Z","timestamp":1761763566000},"page":"1098-1115","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Cost\u2010effectiveness and long\u2010term outcomes of periodontal regeneration versus dental implants: A retrospective study"],"prefix":"10.1002","volume":"97","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-0371-303X","authenticated-orcid":false,"given":"Yousef T.","family":"Amrou","sequence":"first","affiliation":[{"name":"Department of Periodontics and Oral Medicine School of Dentistry University of Michigan  Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdusalam E.","family":"Alrmali","sequence":"additional","affiliation":[{"name":"Department of Periodontics and Oral Medicine School of Dentistry University of Michigan  Ann Arbor Michigan USA"},{"name":"Department of Oral Medicine Oral Pathology, Oral and Maxillofacial Surgery University of Tripoli School of Dentistry  Tripoli Libya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hamzeh","family":"Almashni","sequence":"additional","affiliation":[{"name":"Department of Periodontics and Oral Medicine School of Dentistry University of Michigan  Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pablo","family":"Galindo\u2010Fernandez","sequence":"additional","affiliation":[{"name":"Department of Periodontics and Oral Medicine School of Dentistry University of Michigan  Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hom\u2010Lay","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Periodontics and Oral Medicine School of Dentistry University of Michigan  Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad H. 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