Allan Deutsch
 
 
 
 
 
 
 

A topic that seems to be coming up more and more is “endodontics versus implants, when to do which?” More and articles are being written on the success of endo versus implants. The article below was published in the November 2008 issue of the Journal of Endodontics.

Comparison of Success of Implants Versus Endodontically Treated Teeth
J. P. Hannahan and P. D. Eleazer
Implants versus root canal therapy is a current controversy in dentistry. The purpose of this investigation was to compare the success of each treatment, with minimal subjective grading. Outcome was determined by clinical chart notes and radiographs. Failure was defined as removal of the implant or tooth. Uncertain findings for implants were defined as mobility class I or greater, radiographic signs of bone loss, or an additional surgical procedure. Mobility, periapical index score of 3 or greater, or the need for apical surgery was classified as uncertain for endodontically treated teeth. Success was recorded if the implant or tooth was in place and functional. Implants were placed by periodontists in a group practice, whereas the endodontic treatments were performed by endodontists in group practice. Charts of 129 implants meeting inclusion criteria showed follow-up of an average of 36 months (range, 15-57 months), with a success rate of 98.4%. One hundred forty-three endodontically treated teeth were followed for an average of 22 months (range, 18-59 months), with a success rate of 99.3%. No statistically significant differences were found (P = .56). When uncertain findings were added to the failures, implant success dropped to 87.6%, and endodontic success declined to 90.2%. This difference was not statistically significant (P = .61). We found that 12.4% of implants required interventions, whereas 1.3% of endodontically treated teeth required interventions, which was statistically significant (P = .0003). The success of implant and endodontically treated teeth was essentially identical, but implants required more postoperative treatments to maintain them.

How will general dentists doing root canals react? It is reported that some are bypassing endo altogether and going straight to single-tooth implants. The indications, treatment planning, and considerations are varied; what is your reaction? You can reach me at: adeutsch@edsdental.com.