Implant and root canal treatment: Survival rates and factors associated with treatment outcome.

OBJECTIVES: To assess and compare the survival rates of implant and root canal treatment as well as to investigate the effect of patient and tooth related variables on the treatment outcome in a large-scale population-based study.

METHODS: Dental records of patients who received root canal treatment and implant therapy were retrieved from the electronic records of the University of Minnesota School of Dentistry. Demographic characteristics, dental insurance status, socioeconomic status as well as medical history and tobacco use were recorded. The treatment outcome was included as a binary variable (survival/failure).

RESULTS: A total of 13,434 records of patients who had implant (33.6%) or root canal therapy (66.4%) were included. The survival rate analysis and Kaplan-Meier table revealed the majority of the implants were removed within the first year (58.8%), while only 35.2% of the root canal treatments failed in the same time period. The overall survival rate was significantly (p < 0.001) higher for implant therapy (98.3%) compared to root canal treatment (72.7%). A statistically significant association was found between treatment (p <n0.001), age (p < 0.001) and anxiety (p = 0.004) with treatment outcome CONCLUSIONS: Implant therapy exhibited significantly lower failures when compared to root canal treatment, but the selection of either treatment should be based on multiple factors. Higher age and anxiety were also significantly associated with root canal and implant treatment failure.

CLINICAL SIGNIFICANCE: Clinicians are in an increased dilemma that affects the decision-making process due to the inadequate evidence in regards to the question of retention or extraction of a tooth in the natural dentition. This study demonstrated that both root canal and implant treatments are sound options with high survival rates; however, root canal therapy exhibited a significantly higher failure rate.