The consequences of not replacing a missing posterior tooth

J Am Dent Assoc. 2000 Sep;131(9):1317-23. doi: 10.14219/jada.archive.2000.0385.


Background: Failure to replace a missing posterior tooth is assumed to result in host of adverse consequences, which include shifting of teeth and loss of alveolar bone support.

Methods: A retrospective longitudinal study (median follow-up period 6.9 years), using the radiographs of 111 patients who had an untreated bounded edentulous space, or BES, was conducted to determine the extent to which these adverse outcomes occurred.

Results: The majority of patients lost 1 millimeter or less of the distance between teeth adjacent to the space, extrusion of the opposing tooth was < or = 1 mm in 99 percent of the cases, and the amount of alveolar bone loss next to the adjacent teeth was < or = 1 mm in 83 percent of the cases.

Conclusions: Within the follow-up time in this study, this group of patients did not exhibit the expected adverse consequences with either the frequency or severity generally assumed to be associated with nonreplacement of a single posterior tooth.

Clinical implications: These findings suggest that for the large majority of patients who experience a single-tooth posterior BES, immediate treatment may not be critical to the maintenance of arch stability. Instead, regular follow-up assessments to monitor change in stability and periodontal health may be warranted.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Alveolar Bone Loss / diagnostic imaging
  • Alveolar Bone Loss / etiology*
  • Bicuspid / physiology
  • Dental Arch / diagnostic imaging
  • Dental Arch / physiopathology
  • Female
  • Humans
  • Jaw, Edentulous, Partially / diagnostic imaging
  • Jaw, Edentulous, Partially / physiopathology*
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Molar / physiology
  • Radiography
  • Retrospective Studies
  • Tooth Extraction / adverse effects*
  • Tooth Migration / diagnostic imaging
  • Tooth Migration / etiology*