The success rate of proper root canal treatment is higher than 96%, yet certain percentage of cases still fail due to anatomical complexity, improper root canal preparation or persistence of bacteria in the dentinal tubules.
The presence of endodontically treated teeth that shows a periapical or lateral radiolucency and symptoms of an active endodontic infection requires the clinician to decide whether to retreat the tooth endodontically or to extract it and place an implant-supported crown. Though, endodontically retreated teeth and implants share similar outcomes, the lack of standardized tools for evaluating the results and the different biological mechanisms make it difficult to directly compare both treatment modalities. Whereas, the success of root canal retreatment procedure is defined by complete radiographic healing and the absence of clinical signs and symptoms, the majority of studies on dental implants only refer to survival rates and not to success rates. Many studies reported that the survival rate of implant and endodontic retreatment are both the same. However, the latest findings, related to this subject, were mainly directed to selecting a minimally invasive procedure while providing the best esthetic outcome.
There is great variability among clinicians in establishing a treatment plan. The question that keeps popping is: Which is the best to choose without misleading the patients? To perform between root canal retreatment or to place an implant?
Objectives
- Have an insight about the diagnostic steps required to reach a clinical decision.
- Understand the factors that affect the prognosis of different clinical situations.
- Sum up different clinical tips and tricks used to improve both peri-implant bone and soft tissue at the fresh extraction socket of a hopeless teeth