Comparison Between the Long-Term Survival Rates of Tooth Preservation and Dental Implants: An In Vivo Study

The long-term prognosis of natural teeth and dental implants has been a critical subject in restorative dentistry. While dental implants offer a predictable solution for missing teeth, preserving natural dentition is often preferred when feasible.

A total of 200 participants aged between 25 and 65 years were enrolled in this prospective in vivo study, conducted from January 2014 to January 2024. Group A consisted of 100 patients with endodontically treated and periodontally maintained natural teeth, while Group B included 100 patients rehabilitated with single dental implants. Survival was defined as the functional presence of the tooth/implant without the need for extraction or removal. Patients were evaluated annually for mobility, bone loss, peri-implantitis, or secondary caries using clinical and radiographic criteria. Statistical analysis was conducted using the Kaplan-Meier survival estimate and Chi-square test with significance set at P < 0.05.

After a 10-year follow-up, the overall survival rate was 88% for preserved natural teeth and 92% for dental implants. Group A showed failures primarily due to vertical root fractures and recurrent periodontal infections, while Group B experienced failures due to peri-implantitis and biomechanical overload. The difference in survival was not statistically significant (P = 0.172), indicating comparable long-term outcomes between both interventions.

Tooth preservation and dental implants demonstrated similar long-term survival rates in this study. Preserving natural dentition remains a viable and effective option when clinical conditions permit, with dental implants serving as a reliable alternative when tooth retention is unfeasible.