A new study published in the November issue of the 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, according to a press release from the American Association of Endodontists (AAE).
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) (JOE, November 2008, Vol. 34:11, pp. 1302-1305).
"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, D.M.D., 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 postoperative complications and higher long-term failure rates."
Dr. Hannahan and his colleagues evaluated patient charts of 129 dental implants for an average of 36 months (range, 15-57 months) and of 143 endodontically treated teeth for an average 22 months (range, 18-59 months). Implant data were collected from a periodontic group practice, and root canal data were collected from an endodontic group practice. Researchers placed each procedure into one of three categories: success, uncertain, and failure. Success was defined as radiographic evidence that the implant or treated tooth was still present in the mouth and there were no signs or symptoms requiring intervention during the follow-up treatment period. Failures were defined as the removal of the implant or tooth.
The investigators found two failures of the 129 dental implants for a success rate of 98.4%. They also found only one failure of the 143 endodontic treatments for a success rate of 99.3%. These results were not statistically significant (p = 0.56) with the Fisher exact test, a statistical significance test. However, 12.4% of the dental implants required additional interventions, whereas only 1.3% of the endodontically treated teeth required additional interventions, which was statistically significant (p = 0.0003).
"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 AAE. "While implants may be an appropriate solution for people with missing teeth, endodontic treatment should be the first choice for restoring a compromised tooth."
