Cortellini P, Stalpers G, Mollo A, et al. - In this 10‐year randomized controlled clinical trial, researchers contrasted periodontal regeneration (PR) with tooth extraction and replacement (TER) in a population with attachment loss to or beyond the apex of the root in terms of professional, patient‐reported and economic outcomes. For this analysis, 50 stage III or stage IV periodontitis patients with a severely compromised tooth with attachment loss to or beyond the apex have been randomized to PR or TER with either an implant‐ or a tooth‐supported fixed partial denture. The PR and TER groups reported 88% and 100% survival rates, respectively. Periodontal regeneration will improve the hopeless teeth's prognosis, and is a less costly alternative to tooth extraction and replacement. The complexity of the treatment restricts widespread use to the most difficult situations, but offers clear proof of concept for the advantages of PR in deep intra-bony defect.