This summary is based on the article published in the Journal of Endodontics: Tooth Retention through Endodontic Microsurgery or Tooth Replacement Using Single Implants: A Systematic Review of Treatment Outcomes (January 2015)
Mahmoud Torabinejad, DDS, MSD, PhD, Maria Landaez, DDS, Marites Milan, DDS, MS, Chun Xiao Sun, DDS, MS, Jeffrey Henkin, DDS, MS, Aladdin Al-Ardah, DDS, MS, Mathew Kattadiyil, DDS, MDS, MSD, Khaled Bahjri, MD, DrPH, MPH, Salem Dehom, MPH, Elisa Cortez, MILS,¶ and Shane N. White, BDentSc, MS, MA, PhD
Context
- Clinicians are regularly confronted with difficult choices. Should a tooth that has not healed through nonsurgical root canal treatment (NSRCT) be treated through endodontic microsurgery (EMS) or be replaced using a single implant (SIs)?
- Acquiring complete, unbiased information to help clinicians and their patients make these choices requires a systematic review of the literature on treatment outcomes.
- Long-term survival rates for SIs and NSRCT are remarkably similar 12–17. Other options include extraction and replacement using fixed or removable dental prostheses and extraction without replacement.
- However, fixed and removable prostheses have lower success and survival rates than SIs 13, 18, 19.
- Some evidence suggests that teeth retained through NSRCT have lower complication rates and more favorable economics than SIs 2, 20–28.
Purpose of the Review
To compare the outcomes of tooth retention through endodontic microsurgery to tooth replacement using an implant supported single crown.
Key Findings
- In the event of failure to achieve healing after NSRCT, SI was a superior option to EMS with respect to survival.
- These SI and EMS options are both surgical approaches. However, nonsurgical endodontic retreatment may be an equal or superior alternative.
- The findings of this current study and of a prior study comparing conventional endodontic retreatment with traditional endodontic surgery (TES) suggest that surgical endodontic approaches should not be used as a first-line response to failure in healing after NSRCT 46.
- At 4–6 years, single implants had higher survival rates than teeth treated with endodontic microsurgery.
- Qualitatively different success criteria precluded valid comparison of success rates between treatments.
- Limited psychosocial data indicated that single implant crown patients were well satisfied with esthetics and function.
- The extant literature does not guide clinicians in making patient-specific decisions between single implants and endodontic microsurgery.
References