Treatment planning for implants versus root canal therapy: a contemporary dilemma

The predictability of implant fixtures as a long-term solution for edentulous areas has improved to the point where they have become the standard of care in many situations, in lieu of fixed prostheses. At the same time, the success rate of endodontically treated teeth, and those requiring retreatment, is very high as well. The dilemma presented to the clinician in treatment planning is when to retreat a tooth or extract and place an endosseous root-form implant. Risk assessment for prognostic evaluation plays an important role in the decision-making process. The clinical and systemic factors affecting the longevity of a tooth need be considered as well as location, bone quality and amount, and the condition of the patient's other teeth. This article attempts to provide a meaningful algorithm that will provide a basis for an appropriate choice of therapy.