This research paper by Dr Setzer FC and Dr Kim compares the long-term survival of dental implants against endodontically-treated teeth. It highlights the overall greater success rates of the latter among dental practices. Find below the excerpted abstract and conclusion by its authors:
The outcomes of both dental implants and endodontically treated teeth have been extensively studied. However, there is still a great controversy over when to keep a natural tooth and when to extract it for a dental implant. This article reviews the benefits and disadvantages of both treatment options and discusses success vs. survival outcomes, as well as the impact of technical advances for modern endodontics and endodontic microsurgery on the long-term prognosis of tooth retention.
Market strategies and economic forces have resulted in an ongoing commercialization of clinical practice. If dental education becomes dominated by companies rather than by educators or experienced clinicians, or if fewer cases are handled by specialists, we must not be surprised when the number of implant and/or endodontic complications and/or failures will increase. The survival of implants placed by inexperienced practitioners was 73.0% compared with 95.5% by implant specialists (Morris and Ochi, 2000a,b). A comparison of tooth survival rates after endodontic treatment by endodontic specialists vs. general practitioners, in a multi-center study consisting of 350 teeth that met the inclusion criteria, showed a difference of only 98.1% vs. 89.7% (Alley et al., 2004).
Both implants and endodontically treated teeth demonstrate significant outcome rates if the treatments are appropriately chosen and rendered. However, a missing tooth is irreversibly gone, and a tooth should be removed only after worthwhile deliberation. There is no lifetime guarantee for either a natural tooth or an implant. Both options should be seen as complementing each other, not as competing, and should serve the overall goal in dentistry, the long-term health and benefit of the patient, being least invasive and incorporating function, comfort, and esthetics. To achieve these goals, it is important for clinicians to be fully aware of true long-term outcomes of both implants and endodontically treated teeth.