Periodontal attachment level of extractions presumably performed for periodontal reasons

BACKGROUND/AIMS: The aim of this study was to analyse the residual periodontal attachment in teeth extracted by East German dentists in order to determine a possible 'forceps level'. METHODS: Out of about 8000 extracted teeth collected from a dental waste disposal company, 500 teeth were randomly selected. After exclusion of wisdom teeth and premolars extracted for orthodontic reasons (intact teeth with attachment > 90%), coronal and root caries, fillings, pulp exposure and incomplete root fillings (based on X-rays) were registered. The periodontal ligament was stained with 1% Fuchsin Red and measured with a light microscope. RESULTS: For intact teeth (DF = 0, periodontal disease definition I), the mean periodontal attachment (50.5% +/- 16.0) was significantly lower than for teeth with carious defects or fillings (64.7% +/- 18.8. unpaired t-test: p < 0. 00 1). There was a marked increase in frequency of extractions in intact teeth below 70% periodontal attachment and 37% were extracted at attachment levels between 50 and 69%. Teeth with pulpal involvement showed significantly different frequency distributions and mean attachment values (77.9% +/- 17.8) than the remaining teeth (periodontal disease definition II; 55,2% +/- 15.5). CONCLUSIONS: A considerable number of teeth with no or minor coronal destruction were extracted at an attachment level of 50-70%, regardless of the tooth type. The threshold for 'periodontal' extractions seem to be too low and undifferentiated, which calls for an improvement in knowledge of periodontal diagnosis and treatment.