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Endodontic or dental implant therapy: the factors affecting treatment planning
Mahmoud Torabinejad1, Charles J Goodacre
1Endodontic Residency Program, Department of Endodontics, School of Dentistry, Loma Linda University, CA 92350, USA. mtorabinejad@llu.edu
Background:
Clinicians are confronted with difficult choices regarding whether a tooth with pulpal and/or periapical disease should be saved through endodontic treatment or be extracted and replaced with an implant.
Methods:
The authors examined publications (research, literature reviews and systematic reviews) related to the factors affecting decision making for patients who have oral diseases or traumatic injuries.
Results:
The factors to be considered included patient-related issues (systemic and oral health, as well as comfort and treatment perceptions), tooth- and periodontium-related factors (pulpal and periodontal conditions, color characteristics of the teeth, quantity and quality of bone, and soft-tissue anatomy) and treatment-related factors (the potential for procedural complications, required adjunctive procedures and treatment outcomes).
Conclusions:
On the basis of survival rates, it appears that more than 95 percent of dental implants and teeth that have undergone endodontic treatment remain functional over time.
Clinical Implications:
Clinicians need to consider carefully several factors before choosing whether to perform endodontic therapy or extract a tooth and place an implant. The result should be high levels of comfort, function, longevity and esthetics for patients.
