Elsevier

Dental Abstracts

Volume 59, Issue 4, July–August 2014, Pages 215-216
Dental Abstracts

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To extract or implant?

https://doi.org/10.1016/j.denabs.2013.12.046Get rights and content

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Background

Dental implants are often used to replace “hopeless” or missing teeth, which may lead clinicians to believe they are as good as natural teeth. As a result, teeth that are salvageable may be extracted as a matter of convenience rather than after an analysis of prognostic factors. During such an analysis, the clinician must determine the long-term effectiveness of dental implants and weigh it against that of tooth preservation. A literature review was done to find the long-term survival data for

Methods

The MEDLINE database was searched for publications in English up to March 2013. Criteria used included the long-term effectiveness of dental implants and/or the lifespan of tooth preservation techniques with a follow-up of at least 15 years.

Results

Nine articles assessed tooth survival rates, and 10 assessed implant survival rates. Rates of long-term tooth loss were between 3.6% and 13.4%. For implants, the long-term rates were 0% to 33%. For hopeless or questionable teeth, the tooth loss rates were considerably higher, with hopeless teeth having a loss rate of 20% and questionable teeth a loss rate of 62.3%.

Generally there is a higher rate of implant loss than of tooth loss. Clinicians can use implants at any point to replace extracted

Discussion

The ultimate goal of treatment is to enhance the probability of success by addressing the risks accompanying each possible course of action. Based on the data available, preserving and maintaining a natural tooth as long as possible appears to provide a better solution than extracting the tooth and placing an implant, which is an irreversible decision. Implants can usually be placed later, once the tooth is no longer functional and has become deleterious to the patient's oral health.

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Levin L, Halperin-Sternfeld M: Tooth preservation or implant placement: A systematic review of long-term tooth and implant survival rates. J Am Dent Assoc 144:1119-1133, 2013

Reprints available from L Levin, Faculty of Medicine, Technion, Israel Inst of Technology, Haifa; Dept of Periodontology, School of Graduate Dentistry, Rambam Health Care Campus, Haifa, PO Box 9602, Haifa 31096, Israel; e-mail: [email protected]

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