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A new study published in the November 2008 issue of Journal of Endodontics addresses the growing controversy among dental health professionals regarding the best course of treatment when evaluating between a root canal or dental implant procedure. Researchers evaluated the success and failure rates of teeth treated with a root canal (endodontically treated teeth) or extracted and replaced with a dental implant. While the findings concluded that the success rate of each treatment was similar, the data showed that significantly more dental implants required additional treatment or surgical intervention after the procedure compared to endodontically treated teeth (12.4% versus 1.3%, respectively). “Many dental professionals today are faced with the dilemma of whether root canal treatment or dental implants are the best option for their patients,” said lead investigator James Porter Hannahan, DMD, of the University of Alabama at Birmingham. “While the success of both procedures is similar, saving the natural tooth through a root canal rarely requires follow-up treatment and generally lasts a lifetime; implants, on the other hand, have more post-operative complications and higher long-term failure rates.”
“Considering these results in light of the growing body of evidence on the impact of oral health on overall health, it is imperative for dental professionals to partner with endodontists who have advanced training in examining whether a natural tooth can be saved through root canal treatment,” said Dr. Louis Rossman, an endodontist and president of the American Association of Endodontists (AAE), the dentists who specialize in root canals. “While implants may be an appropriate solution for people with missing teeth, endodontic treatment should be the first choice for restoring a compromised tooth.”
Because of the increasing popularity of dental implants, patients may not realize the long-term implications of the procedure or that root canals may be healthier and less complicated. Dental professionals should explain to patients the differences between each procedure.
When considering treatment options, the AAE emphasizes that decisions must be based on factors other than outcome, such as case complexity or the patient’s individual health and preferences.
To assist dental professionals and their patients in determining the most appropriate treatment, the AAE has formal guidance on treatment planning, which includes evaluating various risk factors and other implications associated with root canal and implant treatment.
Risk factors can include smoking, bone quality, and estrogen levels—for example, women with lower estrogen levels may encounter more treatment failures with implants.
(Source: American Association of Endodontists, November 13, 2008)
