Teeth or implants?

Abstract

One of the main challenges for the modern implantologist is to resolve the clinical dilemma about whether to extract or retain a tooth. At this regard, evidence-based decisions are based on the concepts of survival, success, and failure. These concepts are often not clearly reported in the literature, which may complicate information retrieval from the literature. Comparison of implant solutions with endodontic treatment needs a separate analysis between primary endodontic procedures, re-interventions, and endodontic surgical options. Comparison with fixed prosthesis on natural abutments is best made analyzing separately the success and failure of single crowns and multipleunit restorations. The traumatized tooth may also pose some diagnostic and therapeutic doubts, especially because trauma often involves young patients. Finally, the periodontal compromised patient must have a specific evaluation before implant placement, mainly for the prognostic implications associated with a history of periodontal disease. Development of treatment-decision algorithms in all these situations may aid the clinician in developing a treatment plan.