Factors Affecting Outcomes for Single-Tooth Implants and Endodontic Restorations

An Important Dilemma in Treatment Planning: Implant or Endodontic Therapy?

“…In one study, patients with diabetes showed a reduced likelihood of endodontic success, especially in cases with preoperative periradicular lesions (Fouad & Burleson, 2003). In a matched case-control study, Doyle et al (2007) noted that the outcomes for single-tooth implants and restored endodontically treated teeth were not significantly affected by diabetes; however, preoperative lesions were not reported. In addition, a recent one-year clinical outcome study reported no evidence of diminished clinical success or significant complications related to implant treatment in patients with diabetes (Turkyilmaz, 2010).…”

“…Other authors suggested a possible negative influence of smoking on the prognosis of root canal-treated teeth, but this was mainly attributed to delayed bone healing and to an increased prevalence of periodontal disease and root caries in smokers (Duncan & Pitt Ford, 2006). A recent study by Doyle et al (2007) suggested that smokers had a lower success rate and more failures in both single-tooth implants and endodontic restorations. In patients with high caries activity, especially activity that is possibly related to dry mouth as a common side effect of several medications (e.g., antihypertensives, diuretics, antidepressants, atropine, anticonvulsants, spasmolysants and appetite suppressants) or associated with certain syndromes (e.g., Sjögren), less effort will be made to maintain a compromised tooth, and implant treatment may be favored (Zitzmann et al, 2009).…”

“…If a surgical re-treatment is necessary, extending the life of the crown by replacment with a single implant is less cost effective (Pennington et al, 2009). In addition, www.intechopen.com in terms of post-procedural treatment requirements, the study by Doyle et al (2007) demonstrated that implants required nearly 5 times more post-treatment interventions as compared with restored endodontically treated teeth. Kim & Solomon (2011) evaluated the cost-effectiveness of four different treatment modalities (i.e., nonsurgical retreatment with restoration, endodontic microsurgery, extraction with fixed partial denture, and extraction with single implant-supported restoration) on a hypothetical clinical scenario of a failed endodontically treated first molar.…”

“…A recent study reported that the incidence of retrograde peri-implantitis might be reduced by increasing the distance between the implant and the adjacent tooth, and/or the duration from endodontic treatment to implant placement in the adjacent tooth (Zhou et al, 2009). However, some researchers suggested that the endodontic status of adjacent teeth has no effect on the prognosis of the implant (Shabahang et al, 2003;Doyle et al, 2007;Laird et al, 2008). Local anatomy, such as proximity to the sinus or the type of bone, determines the potential need for additional procedures and/or whether the risk for complications will increase (Bader, 2001(Bader, , 2002Cohn, 2005;Torabinejad & Goodacre, 2006).…”

Tomografia computadorizada de feixe cônico como método de avaliação pós-tratamento endodôntico em sessão única ou em duas sessões

“…Preocupou-se em uniformizar o maior número possível de variáveis independentes, variando somente o número de sessões (com ou sem a utilização de curativo de demora entre sessões). Foram excluídos pacientes diabéticos, pois sabe-se que nesses pacientes o processo de reparo é mais lento (Doyle et al, 2007) e foram utilizados somente dentes unirradiculares, o que possibilitou a redução de viés relacionado às dificuldades inerentes ao tratamento de dentes multirradiculares, como tempo de tratamento, acesso complexo, curvaturas acentuadas, entre outros. As características demográficas como idade, gênero, tipo de dente e arcada foram uniformemente distribuídas entre os dois grupos, reduzindo fontes de variação.…”