Retrospective Cross Sectional Comparison of Initial Nonsurgical Endodontic Treatment and Single-Tooth Implants


      Initial root canal treatment and the replacement of a single tooth with implants are both viable treatment options, but various success rates have been reported for each treatment modality. This study compared 196 implant restorations and 196 matched initial nonsurgical root canal treatment (NSRCT) teeth in patients for four possible outcomes- success, survival, survival with subsequent treatment intervention and failure. Cross classifications/tabulations were analyzed using Pearson’s χ2 test for association of the two classifications (endo vs. implant and outcome). Polytomous regression with likelihood ratio tests were used in testing association with tooth location and outcome. Outcomes were as follows for implants and NSRCT outcomes, respectively: success 73.5% and 82.1%; survival with no intervention 2.6% and 8.2%; survival with intervention 17.9% and 3.6%; and failure 6.1% and 6.1%. Location of the restoration in the mouth did not affect outcome. This study suggests that restored endodontically treated teeth and single-tooth implant restorations have similar failure rates, although the implant group showed a longer average and median time to function and a higher incidence of postoperative complications requiring subsequent treatment intervention.

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        • DeVan M.M.
        The nature of the partial denture foundation.
        J Prosthet Dent. 1952; 2: 210-218
        • Torabinejad M.
        Apples and oranges.
        J Endod. 2003; 29: 541-542
        • Henry P.J.
        Tooth loss and implant replacement.
        Aust Dent J. 2000; 45: 150-172
        • Lewis S.
        Treatment planning.
        Int J Periodontics Restorative Dent. 1996; 16: 366-377
        • Rose L.F.
        • Weisgold A.S.
        Teeth or implants.
        Compend Contin Educ Dent. 1996; 17: 1151-1159
        • Davarpanah M.
        • Martinez H.
        • Tecucianu J.F.
        • Fromentin O.
        • Celletti R.
        To conserve or implant.
        Int J Periodontics Restorative Dent. 2000; 20: 412-422
        • Spear F.
        When to restore, when to remove.
        Compend Contin Educ Dent. 1999; 20: 316-318
        • Bader H.I.
        Treatment planning for implants versus root canal therapy.
        Implant Dent. 2002; 11: 217-223
        • Caplan D.J.
        • Weintraub J.A.
        Factors related to loss of root canal filled teeth.
        J Public Health Dent. 1997; 57: 31-39
        • Artzi Z.
        • Carmeli G.
        • Kozlovsky A.
        distinguishable observation between survival and success rate outcome of hydroxyapatite-coated implants in 5–10 years in function.
        Clin Oral Implants Res. 2006; 17: 85-93
        • Creugers N.H.
        • Kreulen C.M.
        • Snoek P.A.
        • de Kanter R.J.
        A systematic review of single-tooth restorations supported by implants.
        J Dent. 2000; 28: 209-217
        • Friedman S.
        Treatment outcome and prognosis of endodontic therapy.
        in: Orstavik D. Pitt Ford T.R. Essential endodontology prevention and treatment of apical periodontitis. Blackwell Science, Oxford1998
        • Friedman S.
        Prognosis of initial endodontic therapy.
        Endod Topics. 2002; 2: 59-88
        • Lazarski M.P.
        • Walker 3rd, W.A.
        • Flores C.M.
        • Schindler W.G.
        • Hargreaves K.M.
        Epidemiological evaluation of the outcomes of nonsurgical root canal treatment in a large cohort of insured dental patients.
        J Endod. 2001; 27: 791-796
        • Vire D.E.
        Failure of endodontically treated teeth.
        J Endod. 1991; 17: 338-342
        • Orstavik D.
        • Kerekes K.
        • Eriksen H.M.
        The periapical index.
        Endod Dent Traumatol. 1986; 2: 20-34
        • Orstavik D.
        • Horsted-Bindslev P.
        A comparison of endodontic treatment results at two dental schools.
        Int Endod J. 1993; 26: 348-354
        • Trope M.
        • Delano E.O.
        • Orstavik D.
        Endodontic treatment of teeth with apical periodontitis: Single vs. multivisit treatment.
        J Endod. 1999; 25: 345-350
        • Delano E.O.
        • Ludlow J.B.
        • Orstavik D.
        • Tyndall D.
        • Trope M.
        Comparison between PAI and quantitative digital radiographic assessment of apical healing after endodontic treatment.
        Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2001; 92: 108-115
        • Waltimo T.M.
        • Boiesen J.
        • Eriksen H.M.
        • Orstavik D.
        Clinical performance of 3 endodontic sealers.
        Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2001; 92: 89-92
        • Eriksen H.M.
        • Bjertness E.
        • Orstavik D.
        Prevalence and quality of endodontic treatment in an urban adult population in Norway.
        Endod Dent Traumatol. 1998; 4: 122-126
        • Kerekes K.
        • Tronstad L.
        Long-term results of endodontic treatment performed with a standardized technique.
        J Endod. 1979; 5: 83-90
        • Swartz D.B.
        • Skidmore A.E.
        • Griffin Jr, J.A.
        Twenty years of endodontic success and failure.
        J Endod. 1983; 9: 198-202
        • Sjogren U.
        • Hagglund B.
        • Sundqvist G.
        • Wing K.
        Factors affecting the long-term results of endodontic treatment.
        J Endod. 1990; 16: 498-504
        • Fugazzotto P.A.
        • Gulbransen H.J.
        • Wheeler S.L.
        • Lindsay J.A.
        The use of IMZ osseointegrated implants in partially and completely edentulous patients.
        Int J Oral Maxillofac Implants. 1993; 8: 617-621
        • Esposito M.
        • Hirsch J.M.
        • Lekholm U.
        • Thompsen P.
        Biological factors contributing to failures of osseointegrated oral implants. (I). Success criteria and epidemiology.
        Eur J Oral Sci. 1998; 106: 527-551
        • Esposito M.
        • Hirsch J.M.
        • Lekholm U.
        • Thomsen P.
        Biological factors contributing to failures of osseointegrated oral implants. (II). Etiopathogenesis.
        Eur J Oral Sci. 1998; 106: 721-764
        • Cochran D.L.
        A comparison of endosseous dental implant surfaces.
        J Periodontol. 1999; 70: 1523-1539
        • Noack N.
        • Willer J.
        • Hoffman J.
        Long-term results after placement of dental implants.
        Int J Oral Maxillofac Implants. 1999; 14: 748-755
        • Goodacre C.J.
        • Bernal G.
        • Rungcharassaeng K.
        • Kan J.Y.
        Clinical complications with implants and implant prostheses.
        J Prosthet Dent. 2003; 90: 121-132
        • Friedman S.
        • Abitbol S.
        • Lawrence H.P.
        Treatment outcome in endodontics: the Toronto Study. Phase 1: initial treatment.
        J Endod. 2003; 29: 787-793
        • Farzaneh M.
        • Abitbol S.
        • Lawrence H.P.
        • Friedman S.
        Toronto Study. Treatment outcome in endodontics-the Toronto Study. Phase II: initial treatment.
        J Endod. 2004; 30: 302-309
        • Lindh T.
        • Gunne J.
        • Tillberg A.
        • Molin M.
        A meta-analysis of implants in partial edentulism.
        Clin Oral Implants Res. 1998; 9: 80-90
        • ADA Council on Scientific Affairs
        Dental endosseous implants.
        J Am Dent Assoc. 2004; 135: 92-97
        • Zarb G.A.
        • Albrektsson T.
        Towards optimized treatment outcomes for dental implants.
        J Prosthet Dent. 1998; 80: 639-640
        • Friedman S.
        Considerations and concepts of case selection in the management of post-treatment endodontic disease (treatment failure).
        Endod Topics. 2002; 1: 54-78
        • Ray H.A.
        • Trope M.
        Periapical status of endodontically treated teeth in relation to the technical quality of the root filling and the coronal restoration.
        Int Endod J. 1995; 28: 12-18