Endodontics and implants, a catalog of therapeutic contrasts

Dentists may be faced with the choice to retain a tooth by performing endodontic therapy and restoration or to extract the tooth and replace it with an implant and restoration. The purpose of this study was to catalog areas where implant and endodontic therapies differ so as to assist dentists in making treatment decisions and in identifying areas deserving of future research. Differences in diagnostic procedures and prognostic indicators were listed. With respect to treatment outcomes, study designs, success criteria, treatment results, systematic reviews, complications, clinician expertise, and the use of patient-based measures were discussed. The need for clinically applicable consensus statements and treatment protocols was noted. It was concluded that at this time, choices between implant and endodontic therapies cannot be solely based on outcomes measurement evidence; that different modes of outcome measure frustrate direct comparison; that endodontic and implant therapies profoundly differ in many ways; that although rigorous and clearly defined outcome measures have been proposed for use in endodontic and implant outcomes studies, they are very rarely used; that long-term, large, clearly defined studies, with simple and clear outcome measures, for example survival in combination with defined treatment protocols, are needed to measure the clinical performance of endodontic and implant therapies; and it was recognized that broad outcomes data may not be sufficiently specific to directly impact clinical decision making.