The introduction of implants to dentistry has generated much discussion among dentists and the public. Dental implants are made up of titanium and other materials that are compatible with the human body. They are posts that are surgically placed in the jaw, where they function as a sturdy anchor for replacement teeth. Several factors, including tooth location, quality of supporting bone, periodontal status, restorability and systemic factors weigh heavily on the decision to treat a tooth with root canal treatment or to extract and replace the tooth with an implant.
The following conclusions are from the AAE’s Position Statement on Implants:
- Clinical treatment decisions regarding endodontic or implant therapy must always be made in the best interest of the patient.
- These treatment decisions should always be based on the best, most current evidence.
- The decision to treat a tooth endodontically or replace it with an implant must be based on factors other than treatment outcomes.
- Practitioners are ethically bound to inform patients of all reasonable treatment options.
- The standard of care must be applied equally to all practitioners, generalist and specialist alike. Due consideration should be given to patient referral for the evaluation and advice of specialists in retaining natural teeth.
- Endodontic treatment is a most predictable procedure when the clinician accomplishes correct diagnosis, appropriate treatment planning, thorough instrumentation, complete obturation with coronal restoration, and compassionate and effective care.
View the full Position Statement on Implants and read the Spring 2015 issue of ENDODONTICS: Colleagues for Excellence, Treatment Planning: Retention of the Natural Dentition and the Replacement of Missing Teeth.
- PowerPoint® Presentation for Dental Specialists
- Are Dental Implants a Panacea or Should We Better Strive to Save Teeth? (J Dent Res. 2016 Jan;95(1):5-6)
- Is Endodontics Passé? Editorial (OOOOE, October 2008; PDF File) and AAE Letter to the Editor response (OOOOE, April 2009; PDF File)
- Root canals and dental implants equally effective (AGD Impact, August 2007; PDF File)
- Summary (August 2006; PDF File) and Consensus Report (JOMI, Supplement 2007; PDF File) From the Academy of Osseointegration State of the Science in Implant Dentistry Conference
The Editorial Board of the Journal of Endodontics developed a literature-based study guide of topical areas related to endodontics. This study guide is intended to give the reader a focused review of the essential endodontic literature and does not cite all possible articles related to each topic.
The Success and Failure in Endodontics section will review success and failure related to nonsurgical endodontic therapy, nonsurgical endodontic retreatment, and periradicular surgical treatment.
Please note, some journal articles may require a subscription or login.
- Alley BS, Kitchens GG, Alley LW, Eleazer PD. A comparison of survival of teeth following endodontic treatment performed by general dentists or by specialists. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2004;98(1):115-118.
- American Association of Endodontists. Endodontic Implications of Bisphosphonate-Associated Osteonecrosis of the Jaws.
- American Dental Association. ADA Evidence-Based Dentistry website.
- American Dental Association. ADA Policy on Evidence-Based Dentistry.
- American Dental Association. ADA Principles of Ethics and Code of Professional Conduct.
- August M, Chung K, Chang Y, Glowacki J. Influence of estrogen status on endosseous implant osseointegration. J Oral Maxillofac Surg 2001;59(11):1285-1289; discussion 1290-1291.
- Bader HI. Treatment planning for implants versus root canal therapy: a contemporary dilemma. Implant Dent 2002;11(3):217-223.
- Becktor JP, Isaksson S, Sennerby L. Survival analysis of endosseous implants in grafted and nongrafted edentulous maxillae. Int J Oral Maxillofac Implants 2004;19(1):107-115.
- Bragger U, Karoussis I, Persson R, Pjetursson B, Salvi G, Lang N. Technical and biological complications/failures with single crowns and fixed partial dentures on implants: a 10-year prospective cohort study. Clinic Oral Implants Research 2005;16(3):326-334.
- Chee W, Jivraj S. Failures in implant dentistry. Br Dent J 2007;202(3):123-129.
- Christensen GJ. Implant therapy versus endodontic therapy. J Am Dent Assoc 2006;137(10):1440-1443.
- Cochran D. Implant Therapy I. Annals of Periodontology 1996;1:707-791. (No abstract available)
- Cochrane. Cochrane Collaboration Handbook. 2000.
- Creugers NH, Kreulen CM, Snoek PA, de Kanter RJ. A systematic review of single-tooth restorations supported by implants. J Dent 2000;28:209-217.
- Doyle S, Hodges JS, Pesun I, Baisden M, Bowles W. Factors affecting outcomes for single-tooth implants and endodontic restorations. J Endod 2007;33(4):399-402.
- Doyle S, Hodges J, Pesun I, Law A, Bowles W. Retrospective cross-sectional comparison of initial non-surgical endodontic treatment and single-tooth implants. J Endod 2006;32(9):822-827.
- Dugas NN, Lawrence HP, Teplitsky P, Friedman S. Quality of life and satisfaction outcomes of endodontic treatment. J Endod 2002;28(12):819-827.
- Fouad AF, Burleson J. The effect of diabetes mellitus on endodontic treatment outcome: data from an electronic patient record. J Am Dent Assoc 2003;134(1):43-51; quiz 117-118.
- Friedman S, Abitbol S, Lawrence HP. Treatment outcome in endodontics: the Toronto Study. Phase 1: initial treatment. J Endod 2003;29(12):787-793.
- Fugazzotto PA, Beagle JR, Ganeles J, Jaffin R, Vlassis J, Kumar A. Success and failure rates of 9 mm or shorter implants in the replacement of missing maxillary molars when restored with individual crowns: preliminary results 0 to 84 months in function. A retrospective study. J Periodont 2004;75(2):327-332.
- Goodacre CJ, Bernal G, Rungcharassaeng K, Kan JY. Clinical complications with implants and implant prostheses. J Prosthet Dent 2003;90(2):121-132.
- Graskemper JP. The standard of care in dentistry: Where did it come from? How has it evolved? J Am Dent Assoc 2004;135:1449-1455.
- Hannahan JP, Eleazer PD. Comparison of Success of Implants versus Endodontically Treated Teeth. J Endod 2008;34(11):1302-1305.
- Hebballi NB, Ramoni R, Kalenderian E et al. The dangers of dental devices as reported in the Food and Drug Administration Manufacturer and User Facility Device Experience Database. J Am Dent Assoc 2015;146(2):102-110.
- Herrmann I, Lekholm U, Holm S, Kultje C. Evaluation of patient and implant characteristics as potential prognostic factors for oral implant failures. Intl J Oral Maxillofac Implants 2005;20(2):220-230.
- International Journal of Oral & Maxillofacial Implants. Guidelines For The Provision Of Dental Implants. Intl J Oral Maxillofac Implants 2008;23(3).
- Iqbal M, Kim S. For Teeth Requiring Endodontic Treatment, What Are the Difference in Outcome of Restored Endodontically Treated Teeth Compared to Implant-Supported Restorations? Intl J Oral Maxillofac Implants 2007;22(Suppl):96-119.
- Kan JY, Rungcharassaeng K, Kim J, Lozada JL, Goodacre CJ. Factors affecting the survival of implants placed in grafted maxillary sinuses: a clinical report. J Prosthet Dent 2002;87(5):485-489.
- Klokkevold P, Han T. How Do Smoking, Diabetes, and Periodontitis Affect Outcomes of Implant Treatment? Intl J Oral Maxillofac Implants 2007;22(Suppl):173-202.
- Lazarski MP, Walker III WA, Flores CM, Schindler WG, Hargreaves KM. Epidemiological evaluation of the outcomes of nonsurgical root canal treatment in a large cohort of insured dental patients. J Endod 2001;27(12):791-796.
- Levine RA, Clem DS, Wilson Jr. TG, Higginbotham, F, Solnit G. Multicenter retrospective analysis of the ITI implant system used for single-tooth replacements: results of loading for 2 or more years. Intl J Oral Maxillofac Implants 1999(4);14:516-520.
- McDermott NE, Chuang SK, Woo VV, Dodson TB. Complications of dental implants: identification, frequency, and associated risk factors. Intl J Oral Maxillofac Implants 2003;18(6):848-855.
- Mindiola MJ, Mickel AK, Chogle S, Jones JJ, Lalumandier JA, Nelson SS. Endodontic treatment in an American Indian population: a 10-year retrospective study. J Endod 2006;32(9):828-832.
- Morris HF, Ochi S, Winkler S. Implant survival in patients with type 2 diabetes: placement to 36 months. Ann Periodontol 2000;5(1):157-165.
- Noack N, Willer J, Hoffmann J. Long-term results after placement of dental implants: a longitudinal study of 1,964 implants over 16 years. Int J Oral Maxillofac Implants 1999;14(5):748-755.
- Pjetursson BE, Lang NP. Prosthetic treatment planning on the basis of scientific evidence. J Oral Rehab 2008;35(s1):72-79.
- Ray HA, Trope M. Periapical status of endodontically treated teeth in relation to the technical quality of the root filling and the coronal restoration. Int Endod J 1995;28(1):12-18.
- Salehrabi R, Rotstein I. Endodontic treatment outcomes in a large patient population in the USA: an epidemiological study: an epidemiological study. J Endod 2004;30(12):846-850.
- Starck WJ, Epker BN. Failure of osseointegrated dental implants after bisphosphonate therapy for osteoporosis: a case report. Intl J Oral Maxillofac Implants 1995;10(1):74-78.
- Sutherland SE, Matthews DC. Conducting systematic reviews and creating clinical practice guidelines in dentistry: lessons learned. J Am Dent Assoc 2004;135:747-753.
- Torabinejad M, Anderson P, Bader J, Brown LB, Chen LH, Goodacre CJ, Kattadiyil MT, Kutsenko D, Lozada J, Patel R, Petersen F, Puterman I, White SN. Outcomes of root canal treatment and restoration, implant-supported single crowns, fixed partial dentures, and extraction without replacement: A systematic review. J Pros Dent 2007; 98(4):285-311.
- Torabinejad M, Cymerman JJ, Frankson M, Lemon RR, Maggio JD, Schilder H. Effectiveness of various medications on postoperative pain following complete instrumentation. J Endod 1994;20(7):345-354.
- Torabinejad, M, Goodacre, CJ. Endodontic or dental implant therapy: The factors affecting treatment planning. J Am Dent Assoc 2006;137(7):973-977.
- Tronstad L, Asbjornsen K, Doving L, Pedersen I, Eriksen HM. Influence of coronal restorations on the periapical health of endodontically treated teeth. Endod Dent Traumatol 2000;16(5):218-221.
- van Steenberghe D, Quirynen M, Molly L, Jacobs R. Impact of systemic diseases and medication on osseointegration. Periodontol 2000 2003;33(1):163-171.
- Vehemente VA, Chuang SK, Daher S, Muftu A, Dodson TB. Risk factors affecting dental implant survival. J Oral Implantol 2002;28(2):74-81.
- Walton JN, MacEntee MI. Choosing or refusing oral implants: a prospective study of edentulous volunteers for a clinical trial. Int J Prosthodont 2005;18(6):483-488.
- White S, Akhparyan E, Kutshenko D, Torabinejad M. Endodontics and Tooth Retention. Intl J Prosthodont 2007;20(4):343-344. (No abstract available)
- White, SN. Complementary Therapies, Not Competing Treatments. Intl J Prosthodont 2008;21(1).
- White SN, Miklus V, Potter K, Cho J. Endodontics and Implants, a Catalog of Therapeutic Contrasts. J Evid Base Dent Pract 2006;6(1):101-109.
- Wolcott J, Meyers J. Endodontic Retreatment or Implants: A Contemporary Conundrum. Compend Contin Educ Den 2006;27(2):104-110.
- Wooltorton E. Patients receiving intravenous bisphosphonates should avoid invasive dental procedures. J Canad Med Assoc 2005;172:1684.