An extracted tooth used as a pontic

Chronic periodontitis is characterized with destruction of the periodontal apparatus. It is classified as localized or generalized.1 It is further classified as mild, moderate or severe, according to the degree of the destruction of the periodontium.1^,2 Several clinical parameters, such as bleeding on probing, periodontal pocket depth and clinical attachment level, are used in diagnosis of the disease.1^,2^,3 Treatment of chronic periodontitis involves oral hygiene education, scale and polish and root debridement, as well as regular evaluation and maintenance.1^,3 However, when the periodontal disease has reached an advanced stage, the involved teeth cannot be retained and should be extracted.

In this clinical tip, a 52-year-old female presented with a painful lower left central incisor. Clinical and radiographical examinations revealed the presence of moderate generalized chronic periodontitis, with a localized severe chronic periodontitis in the lower anterior region (Figures 1 and 2). The lower left central incisor was tender to percussion with grade III mobility. The patient was anxious to keep her teeth and to avoid wearing an immediate partial denture, replacing the lower left central incisor as proposed. One of the options, on which the patient agreed, was to extract the tooth and then re-fix it (as a pontic) to the neighbouring teeth using a composite resin restoration. The patient was made aware that the proposed treatment would be a provisional one and that a more permanent treatment may be required in the near future.