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Implants or Endodontics ? What is ethical.

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bijounmepani's picture
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What should be the practical criteria and systematic process to aid the treatment planning decision of whether to preserve teeth by root canal treatment (RCT) or extract and provide an implant.

Your Recommendations Please ., .,

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Anonymous
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Re: Implants or Endodontics ? What is ethical.

obviously endo. if the tooth can be saved endo would always be preferable

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sushantpatel_doc's picture
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Re: Implants or Endodontics ? What is ethical.

RCT is both conservative and economical..it has to be the only option..

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Anonymous
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Re: Implants or Endodontics ? What is ethical.

a better way to paraphrase would be "Perio or implants" . with the advent of implants it is now no longer necessary to do heroic periodontics.

however I would bet for perio.

implants are still expensive, require considerable surgical skill and expertise , and also requires patient motivation and co-operation for follow-up and maintenance.
(patient motivation and co-operation are required after heroic periodontics also).

Regards,

Veerendra Darakh

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mithilamhapankar's picture
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Re: Implants or Endodontics ? What is ethical.

There is no material that can replace a natural tooth....hence the obvious option is a RCT
Though it is left upto the clinicians discretion as to what the prognosis of the tooth would be....a second opinion is always helpful.

A pointer in cases of FPD where an abutment would be an implant, one must take care that if one of the abutments is an implant and the other is a natural tooth, such a condition isn't favourable, this is because a combination abutment of natural and implant tooth would lead to undue forces on the natural toooth
This is because the natural tooth has some amount of physiologic mobility where as an implanted abutment doesn't, this leads to unbalanced forces leading to future failure of the fpd.

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drrajvanshi's picture
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Re: Implants or Endodontics ? What is ethical.

[quote="bijounmepani"]What should be the practical criteria and systematic process to aid the treatment planning decision of whether to preserve teeth by root canal treatment (RCT) or extract and provide an implant.

I feel extraction is the last option. I have another view. Can a natural extracted tooth (Without Carious Lession but extracted because of complete loss of periodontal attachment and 3rd grade mobility) be implanted in place of metalic implants?

My study on intentional replants of 465 cases that I carried out in my Clinic, over a period of 25 -26 years, suggests that an Intentionally Replanted Tooth has a pretty long life and provides a cheaper and more assured acceptance than a metal implant. Results are visible after 3-4 weeks.

Your Recommendations Please ., .,[/quote]

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sushantpatel_doc's picture
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Re: Implants or Endodontics ? What is ethical.

If replantation has a great success rate, it is really a great alternative to implants considering that it can prove to be cheaper..

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sushantpatel_doc's picture
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Re: Implants or Endodontics ? What is ethical.

Root Canal Therapy vs. Dental Implants
Which is Right for Me?
A controversy in the dental community currently exists concerning the success rate of root canal therapy when compared with that of implant treatment. Saving your natural tooth should always be your first choice when dental care is needed. Nothing, not even the most advanced bridges and implants, can truly replace your natural tooth. If your dentist recommends extracting your tooth, ask if it can be saved with an endodontic procedure, also known as root canal treatment. Endodontic treatment removes the injured pulp (soft inner tissue) of your tooth and fills and seals the space. Your tooth is then restored and can function just like any other tooth for the rest of your life, ensuring comfortable chewing and a natural appearance.

If your tooth cannot be saved - and some cannot - you may consider replacements such as a bridge or dental implant. Your options may depend upon the condition of surrounding teeth and bone structure. Dental implant procedures can be complex, costly and they often require several visits and up to a year of healing before the procedure can be completed.

At the heart of the controversy is the definition of success. Dental implants are a very valuable in the replacement of missing teeth; however, their success is determined quite differently than that of root canal therapy. With implants, success can have many different definitions, including those that would be considered by many clinicians and patients as failure. The definition of success with root canal therapy is generally defined as a functional tooth with no symptoms and no evidence of disease.

That being said, the success rates of both procedures are very comparable, even with the inaccuracy of the definitions. The goal of root canal therapy is to preserve your natural teeth, where as implants are more geared toward replacing missing teeth or replacing teeth which are not amenable to root canal therapy.

Having root canal therapy does not prevent you from having implant therapy if needed in the future; however, implant therapy does preclude you from any procedure that would maintain your natural tooth.

Nothing is as good as your natural tooth!

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dixitclinic's picture
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Re: Implants or Endodontics ? What is ethical.

Propriception is the unique property provided by the attachment/ periodontal apparatus. Predictable treatment outcome and continuation of disease free condition remains the goal.This may be in the acheived by salvaging the tooth or sacrificing it.

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Dr V.S. Dixit, MDS, Endodontist

Dr V.S. Dixit, MDS, Endodontist