Implant based versus endodontic treatment concepts for anterior teeth

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Andrzej Szwarczyński

1/2014/XLII s. 57–64
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Fraza do cytowania: Szwarczyński A. Implant based versus endodontic treatment concepts for anterior teeth. Dental Forum. 2014;XLII(1):57–64.

Introduction. Patients expect not only a fully functional restoration, but also an aesthetically pleasing and a long-lasting solution. Especially in the anterior region, aesthetics plays a vital role in treatment. Therefore, a practitioner needs to make a considerate choice between any treatment modality. Aim of the study. The aim of this paper is to present and compare methods of treating the anterior teeth in the aesthetic area, especially to compare root canal treatment (RCT) as opposed to implant-supported crowns (ISC) as far as their effectiveness, longevity and possible complications are concerned. Material and methods. PubMed and Medline were queried for all studies that compared non surgical root canal therapy and restoration with the extraction of teeth and placement of a dental implant. The full text of 58 articles related to the studied subject were analysed. Results. The effectiveness of implant and endodontic therapy is similar only in the first 6 years after treatment is completed. Over time a significant decrease in survival rates is observed for endodontically treated teeth, while for implants this fall is markedly lower. Conclusions. 1. A dentist should present to a patient both methods, their advantages, disadvantages and risks. 2. If RCT is risky due to root canal anatomy, especially in multi-rooted teeth, the implant option should be considered. The expected aesthetic effects should be considered, especially in the anterior area. Implant insertion does not always give a favourable and expected aesthetic result if this is not preceded by gingival and bony tissue preparation. The bony and soft tissue quality should be considered. Any bone density abnormalities or bone deficits seen on radiograms should help a dentist decide on RCT procedures or bone augmentation. 3. Properly done implanto-prosthetics preceded by a detailed analysis of the underlying tissues, of radiograms, and of diagnostic models should result in restoring the anatomical and physiological function of the lost tooth. 4. The decision on RCT or implant treatment should be taken following consultation from specialists in both these modalities and an assessment of the restoration survival time for both methods.

Słowa kluczowe: root canal therapy, dental implants, survival rate.

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