References

Gatten DL, Riedy CA, Hong SK, Johnson JD, Cohenca N. Quality of life of endodontically treated versus implant treated patients: a university-based qualitative research study. J Endod. 2011; 37:903-909
Dostálová T, Radina P, Seydlová M, Zvárová J, Valenta Z. Overdenture–implants versus teeth–quality of life and objective therapy evaluation. Prague Med Rep. 2009; 110:332-342
Lang-Hua BH, McGrath CPJ, Lo ECM, Lang NP. Factors influencing treatment decision-making for maintaining or extracting compromised teeth. Clin Oral Implants Res. 2014; 25:59-66
Azarpazhooh A, Dao T, Figueiredo R, Krahn M, Friedman S. A survey of dentists' preferences for the treatment of teeth with apical periodontitis. J Endod. 2013; 39:1226-1233
Stockhausen R, Aseltine R, Matthews J, Kaufman B. The perceived prognosis of endodontic treatment and implant therapy among dental practitioners. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2011; 111:42-47
Iqbal MK, Kim S. For teeth requiring endodontic treatment, what are the differences in outcomes of restored endodontically treated teeth compared to implant-supported restorations?. Int J Oral Maxillofac Implants. 2007; 22:(Suppl)96-116
Strindberg LZ. The dependence of the results of pulp therapy on certain factors – an analytical study based on radiographic and clinical follow-up examinations. Acta Odontol Scand. 1956; 14:1-175
Albrektsson T, Zarb G, Worthington P, Eriksson AR. The long-term efficacy of currently used dental implants: a review and proposed criteria of success. Int J Oral Maxillofac Implants. 1986; 1:11-25
Doyle SL, Hodges JS, Pesun IJ, Law AS, Bowles WR. Retrospective cross sectional comparison of initial nonsurgical endodontic treatment and single-tooth implants. J Endod. 2006; 32:822-827
Ng Y-L, Mann V, Gulabivala K. A prospective study of the factors affecting outcomes of nonsurgical root canal treatment: part 1: periapical health: outcome of nonsurgical root canal treatment. Int Endod J. 2011; 44:583-609
Ng Y-L, Mann V, Gulabivala K. Tooth survival following non-surgical root canal treatment: a systematic review of the literature. Int Endod J. 2010; 43:171-189
Ray HA, Trope M. Periapical status of endodontically treated teeth in relation to the technical quality of the root filling and the coronal restoration. Int Endod J. 1995; 28:12-18
Tickle M, Milsom K, Qualtrough A, Blinkhorn F, Aggarwal V. The failure rate of NHS funded molar endodontic treatment delivered in general dental practice. Br Dent J. 2008; 204
Pratt I, Aminoshariae A, Montagnese TA, Williams KA, Khalighinejad N, Mickel A. Eight-year retrospective study of the critical time lapse between root canal completion and crown placement: its influence on the survival of endodontically treated teeth. J Endod. 2016; 42:1598-1603
Mannocci F, Bertelli E, Sherriff M, Watson TF, Ford TR. Three-year clinical comparison of survival of endodontically treated teeth restored with either full cast coverage or with direct composite restoration. J Prosthet Dent. 2002; 88:297-301
Salehrabi R, Rotstein I. Endodontic treatment outcomes in a large patient population in the USA: an epidemiological study. J Endod. 2004; 30:846-850
Ray HA, Trope M. Periapical status of endodontically treated teeth in relation to the technical quality of the root filling and the coronal restoration. Int Endod J. 1995; 28:12-18
Swanson K, Madison S. An evaluation of coronal microleakage in endodontically treated teeth. Part I. Time periods. J Endod. 1987; 13:56-59
Alves J, Walton R, Drake D. Coronal leakage: endotoxin penetration from mixed bacterial communities through obturated, post-prepared root canals. J Endod. 1998; 24:587-591
Duncan H, Pitt Ford T. The potential association between smoking and endodontic disease. Int End J. 2006; 39:843-854
Evans G, Bishop K, Renton T.: RCS: Faculty of Dental Surgery; 2012
von Arx T, Peñarrocha M, Jensen S. Prognostic factors in apical surgery with root-end filling: a meta-analysis. J Endod. 2010; 36:957-973
Eliyas S, Vere J, Ali Z, Harris I. Micro-surgical endodontics. Br Dent J. 2014; 216:169-177
Del Fabbro M, Corbella S, Sequeira-Byron P, Tsesis I, Rosen E, Lolato A Endodontic procedures for retreatment of periapical lesions. Cochrane Database Syst Rev. 2016; 10
Setzer FC, Kohli MR, Shah SB, Karabucak B, Kim S. Outcome of endodontic surgery: a meta-analysis of the literature – Part 2: Comparison of endodontic microsurgical techniques with and without the use of higher magnification. J Endod. 2012; 38:1-10
Abbott PV. Assessing restored teeth with pulp and periapical diseases for the prescence of cracks, caries and marginal breakdown. Aust Dent J. 2004; 49:33-39
Abbott PV. Incidence of root fractures and methods used for post removal. Int Endod J. 2002; 35:63-67
Chaudhuri A, Buth S, Briggs P. The importance of a bitewing radiograph in the endodontic assessment of posterior teeth. Dent Update. 2014; 41:280-281
Goodacre CJ. Designing tooth preparations for optimal success. Dent Clin North Am. 2004; 48:359-385
McDonald A, Setchell D. Developing a tooth restorability index. Dent Update. 2005; 32:343-348
Dawood A, Patel S. The Dental Practicality Index – assessing the restorability of teeth. Br Dent J. 2017; 222:755-758
Salvi GE, Siegrist Guldener BE, Amstad T, Joss A, Lang NP. Clinical evaluation of root filled teeth restored with or without post-and-core systems in a specialist practice setting. Int Endod J. 2007; 40:209-215
Creugers N, Mentink A, Fokkinga W, Kreulen C. 5-year follow-up of a prospective clinical study on various types of core restorations. Int J Prosthodont. 2005; 18:34-39
Brånemark P-I. Osseointegration and its experimental background. J Prosthet Dent. 1983; 50:399-410
Brånemark P-I, Breine U, Adell R, Hansson BO, Lindstöm J, Ohlsson Å. Intra-osseous anchorage of dental prostheses. I. Experimental studies. Scand J Plast Reconstr Surg. 1969; 3:81-100
Brånemark P-I, Hansson BU, Adell R, Biene U, Lindström J, Hallen O, Öhman A. Osseointegrated implants in the treatment of the edentulous jaw. Experience from a 10-year period. Scand J Plast Reconstr Surg. 1977; 2:1-132
Zarb G, Albrektsson T. Osseointegration: a requiem for the periodontal ligament?. Int J Periodont Restor Dent. 1991; 11:88-91
Adell R, Lekholm U, Rockler B, Brånemark P-I. A 15-year study of osseointegrated implants in the treatment of the edentulous jaw. Int J Oral Surg. 1981; 10:387-416
Wennerberg A, Albrektsson T. Effects of titanium surface topography on bone integration: a systematic review. Clin Oral Implants Res. 2009; 20:172-184
Oliva J, Oliva X, Oliva J. Five-year success rate of 831 consecutively placed zirconia dental implants in humans: a comparison of three different rough surfaces. Int J Oral Maxillofacial Implants. 2010; 25:336-344
Jemt T. Single-implant survival: more than 30 years of clinical experience. Int J Prosthodont. 2016; 30:551-558
Jung RE, Zembi A, Pjetursson BE, Zwahlen M, Thoma DS. Systematic review of the survival rate and the incidence of biological, technical, and aesthetic complications of single crowns on implants reported in longitudinal studies with a mean follow-up of 5 years. Clin Oral Impl Res. 2012; 23:2-21
Pjetursson BE, Brägger U, Lang NP, Zwahlen M. Comparison of survival and complication rates of tooth-supported fixed dental prostheses (FDPs) and implant-supported FDPs and single crowns (SCs). Clin Oral Impl Res. 2007; 18:97-113
Pjetursson B, Thoma D, Jung R, Zwahlen M, Zembic A. A systematic review of the survival and complication rates of implant-supported fixed dental prostheses (FDPs) after a mean observation period of at least 5 years. Clin Oral Impl Res. 2012; 23:22-38
Heitz-Mayfield LJ, Needleman I, Salvi GE, Pjetursson BE. Consensus statements and clinical recommendations for prevention and management of biologic and technical implant complications. Int J Oral Maxillofac Implants. 2014; 29:(Suppl)346-350
Kinsel RP, Lin D. Retrospective analysis of porcelain failures of metal ceramic crowns and fixed partial dentures supported by 729 implants in 152 patients: patient-specific and implant-specific predictors of ceramic failure. J Prosthet Dent. 2009; 101:388-394
Lang NP, Berglundh T Periimplant diseases: where are we now? – Consensus of the Seventh European Workshop on Periodontology. J Clin Periodontol. 2011; 38:178-181
Donos N, Laurell L, Mardas N. Hierarchical decisions on teeth vs. implants in the periodontitis-susceptible patient: the modern dilemma. Periodontology 2000. 2012; 59:89-110
Hugoson A, Laurell L. A prospective longitudinal study on periodontal bone height changes in a Swedish population. J Clin Periodontol. 2000; 27:665-674
Wennström JL Periodontal conditions of adult regular dental care attendants. J Clin Periodontol. 1993; 20:714-722
Albrektsson T, Zarb G, Worthington P, Eriksson AR. The long-term efficacy of currently used dental implants: a review and proposed criteria of success. Int J Oral Maxillofac Implants. 1986; 1:11-25
Albrektsson T “Peri-implantitis”: a complication of a foreign body or a man-made “disease”. Facts and fiction. Clin Implant Dent Relat Res. 2016; 18:840-849
Derks J, Schaller D, Håkansson J, Wennström JL, Tomasi C, Berglundh T. Effectiveness of implant therapy analyzed in a Swedish population: prevalence of peri-implantitis. J Dent Res. 2016; 95:43-49
Roos-Jansåker AM, Renvert H, Lindahl C, Renvert S. Nine- to fourteen-year follow-up of implant treatment. Part II: presence of peri-implant lesions. J Clin Periodontol. 2006; 33:290-295
Zitzmann NU, Berglundh T. Definition and prevalence of peri-implant diseases. J Clin Periodontol. 2008; 35:286-291
De Bruyn H, Christiaens V, Doornewaard R, Jacobsson M, Cosyn J Implant surface roughness and patient factors on long-term peri-implant bone loss. Periodontology 2000. 2017; 73:218-227
Chrcanovic BR, Albrektsson T, Wennerberg A. Smoking and dental implants: a systematic review and meta-analysis. J Dent. 2015; 43:487-498
Chrcanovic BR, Albrektsson T, Wennerberg A. Periodontally compromised vs. periodontally healthy patients and dental implants: a systematic review and meta-analysis. J Dent. 2014; 42:1509-1527
Kasat V, Ladda R. Smoking and dental implants. J Int Soc Prev Community Dent. 2012; 2:38-41
Lang NP, Tonetti MS. Periodontal diagnosis in treated periodontitis. Why, when and how to use clinical parameters. J Clin Periodontol. 1996; 3:240-250
Lang N, Adler R, Joss A, Nyman S. Absence of bleeding on probing. An indicator of periodontal stability. J Clin Perio. 1990; 17:714-721
Matuliene G, Pjetursson B, Salvi G, Schmidlin K, Bragger U, Zwahlen M, Lang NP. Influence of residual pockets on progression of periodontitis and tooth loss: results after 11 years of maintenance. J Clin Perio. 2008; 25:685-695
Zitzmann N, Krastl G, Hecker H, Walter C, Weiger R. Endodontics or implants? A review of decisive criteria and guidelines for single tooth restorations and full arch reconstructions. Int Endod J. 2009; 42:757-774
Chrcanovic BR, Albrektsson T, Wennerberg A. Diabetes and oral implant failure: a systematic review. J Dent Res. 2014; 93:859-867
Goodacre CJ, Bernal G, Rungcharassaeng K, Kan JY. Clinical complications with implants and implant prostheses. J Prosthet Dent. 2003; 90:121-132
Sendyk DI, Chrcanovic BR, Albrektsson T, Wennerberg A, Zindel Deboni MC. Does surgical experience influence implant survival rate? A systematic review and meta-analysis. Int J Prosthodont. 2017; 30:341-347
Chrcanovic BR, Albrektsson T, Wennerberg A. Tilted versus axially placed dental implants: a meta-analysis. J Dent. 2014; 43:149-170
Chrcanovic BR, Albrektsson T, Wennerberg A. Immediate nonfunctional versus immediate functional loading and dental implant failure rates: a systematic review and meta-analysis. J Dent. 2014; 42:1052-1059
Drummond MF, Sculpher MJ, Torrance GW, O'Brien BJ, Stoddart GL., 3rd edn. Oxford: Oxford University Press; 2005
Pennington MW, Vernazza CR, Shackley P, Armstrong NT, Whitworth JM, Steele JG. Evaluation of the cost-effectiveness of root canal treatment using conventional approaches versus replacement with an implant. Int Endod J. 2009; 42:874-883
Buhler H. Evaluation of root-resected teeth. Results after 10 years. J Periododontol. 1988; 59:805-810
Torabinejad M, Landaez M, Milan M Tooth retention through endodontic microsurgery or tooth replacement using single implants: a systematic review of treatment outcomes. J Endod. 2015; 41:1-10
Alani A, Bishop K, Renton T, Djemal S. Update on guidelines for selecting appropriate patients to receive treatment with dental implants: priorities for the NHS – the position after 15 years. Br Dent J. 2014; 217:189-190

Endodontics or implants?

From Volume 45, Issue 6, June 2018 | Pages 506-521

Authors

Jennifer Fuller

BDS(Hons), BSc(Hons), MJDF RCS(Eng)

SHO in Oral and Maxillofacial Surgery Bristol Royal Infirmary, Marlborough Street, Bristol BS1 3NU, UK

Articles by Jennifer Fuller

Peter Briggs

BS(Hons), MSc, MRD RCS(Eng), FDS RCS(Eng)

Consultant, Restorative Department, GKT Dental Institute and St George's Hospital, London

Articles by Peter Briggs

George Bourne

BDS, MFDS RCS(Ed)

Specialty Registrar in Restorative Dentistry, Royal London Dental Hospital; Practitioner, Chelsea, London, SW10 9NA, UK

Articles by George Bourne

Abstract

Abstract: When faced with a tooth that is failing due to pulpal or periapical infection, a difficult treatment planning decision must be made between retention of the tooth through endodontic treatment or extraction and potential replacement with a dental implant. Survival rates for these treatment modalities appear similar from the literature. This review article attempts to explore different factors that should be taken into consideration, in particular the available evidence, predictability and risks of treatment, patient centred-outcomes and cost-effectiveness of the different treatment options.

CPD/Clinical Relevance: This review article aims to provide an overview of the recent evidence and factors to consider, to aid in treatment planning decisions between endodontic treatment and dental implant replacement for a failing tooth.

Article

Endodontic treatment and implant placement are two different treatment modalities that can be utilized to restore function for a patient. When presented with a tooth that has pulpal or periapical infection and a potentially poor prognosis, a number of factors need to be taken into account; these include patient preferences, tooth and periapical factors and evidence-based outcome for both treatment options.

Endodontic treatment aims to treat and maintain the tooth through either non-surgical or surgical approaches, whereby placement of a dental implant improves function by replacing a missing or a tooth of hopeless prognosis. Outcome studies on both treatment modalities appear to yield similar results, however, it must be emphasized that success criteria for outcome in endodontic treatment is strict when compared to that of implants.

There are a number of factors that can influence the outcome of each of the treatment options and knowledge of these is paramount when making an informed decision. Table 1 summarizes some of the main factors to take into consideration for treatment planning when presented with a tooth with infection and a potentially poor prognosis.

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