Longevity of natural teeth surpass the dental implants.
February 16, 2009
A lot of marketing has been done in the past few years to present dental implants as a better choice than a tooth that can be retained with endodontic therapy.
This has resulted in many un-necessary extractions, increase in implant failures, associated lawsuits and complaints to the states board.
Recently the academic community in the fields of periodontics and prosthodontics have come out with some evidence-based recommendations regarding natural teeth vs. dental implants.
For those of you who may be interested, here are some quotes from these articles
Periodontology 2000
Lundgren D, Rylander H, Laurell L
Vol 47, 2008: 27-50
“It is well documented that properly treated natural teeth with healthy but markedly reduced periodontal support, are capable of carrying extensive fixed prosthesis for a very long time, with survival rates of about 90%,provided the periodontal disease is eradicated and prevented from re-occuring.”
“Based on assumptions that implants perform better than periodontally compromised teeth, teeth that could be saved and used as support, are extracted and replaced with implants, sometimes on doubtful indications.”
Peri-impantitis (loss of at least 2 mm of marginal bone) at one or more implants have been found to occur in 16-28% of implant patients after 5-10 years and with higher prevalence among patients with multiple implants.
“The natural tooth should not be considered an obstacle but a possibility, whether or not the treatment is to include implant placement.”
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Journal of Clinical Oral Implant Research
Holm-Pedersen P, Lang N, Muller F
University of Copenhagen
2007, 18(suppl) 15-19
“Oral Implants when evaluated after 10 years of service do not surpass the longevity of natural teeth even of those that are compromised, for either periodontal or endodontic reason. “
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Journal of Oral Rehabilitation;
2008,35 (suppl.1) 2-8
Consensus statements and recommendations of the European Conference on Evidence-based Reconstructive Dentistry: Implants and/or teeth
(Gathering of major European researchers and clinicians who were periodontists and prosthodntists )
Some of the recommendations were Implants do not have a better prognosis than teeth with reduced marginal bone support.
Dentist should not recommend extraction of these teeth.
There is no evidence available to support an aggressive approach in early extraction of teeth, to preserve bone for later implant placement.
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Journal of Prosthodontics ; 2008, Volume 17: 345-347
Editorial : Inconvenient truths by George Zarb,DDS ( Dr Zarb is one of the pioneers of the field of implantology)
“The integrity of purpose and scientific rigor that characterized the original osseo-integration clinical research has been largely discarded as passe’.”
“Partnership with commercial enterprise now dominate continuing education.”
“New lecture circuit celebrities keep being recruited to promote osseo-integration's newer and expanded promises, albeit it falls significantly outside the technique’s initial oral ecological context.”
“We risk overlooking safety, simplicity and prudence in our clinical judgment.”
“The risk of yet another anarchic phase in treatment decision making has resurfaced."
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I think these statements speak for themselves.
I welcome your comments.
Robert Salehrabi,DDS
February 16, 2009
A lot of marketing has been done in the past few years to present dental implants as a better choice than a tooth that can be retained with endodontic therapy.
This has resulted in many un-necessary extractions, increase in implant failures, associated lawsuits and complaints to the states board.
Recently the academic community in the fields of periodontics and prosthodontics have come out with some evidence-based recommendations regarding natural teeth vs. dental implants.
For those of you who may be interested, here are some quotes from these articles
Periodontology 2000
Lundgren D, Rylander H, Laurell L
Vol 47, 2008: 27-50
“It is well documented that properly treated natural teeth with healthy but markedly reduced periodontal support, are capable of carrying extensive fixed prosthesis for a very long time, with survival rates of about 90%,provided the periodontal disease is eradicated and prevented from re-occuring.”
“Based on assumptions that implants perform better than periodontally compromised teeth, teeth that could be saved and used as support, are extracted and replaced with implants, sometimes on doubtful indications.”
Peri-impantitis (loss of at least 2 mm of marginal bone) at one or more implants have been found to occur in 16-28% of implant patients after 5-10 years and with higher prevalence among patients with multiple implants.
“The natural tooth should not be considered an obstacle but a possibility, whether or not the treatment is to include implant placement.”
------------------------------------------------------------------------------
Journal of Clinical Oral Implant Research
Holm-Pedersen P, Lang N, Muller F
University of Copenhagen
2007, 18(suppl) 15-19
“Oral Implants when evaluated after 10 years of service do not surpass the longevity of natural teeth even of those that are compromised, for either periodontal or endodontic reason. “
-----------------------------------------------------------------------------
Journal of Oral Rehabilitation;
2008,35 (suppl.1) 2-8
Consensus statements and recommendations of the European Conference on Evidence-based Reconstructive Dentistry: Implants and/or teeth
(Gathering of major European researchers and clinicians who were periodontists and prosthodntists )
Some of the recommendations were Implants do not have a better prognosis than teeth with reduced marginal bone support.
Dentist should not recommend extraction of these teeth.
There is no evidence available to support an aggressive approach in early extraction of teeth, to preserve bone for later implant placement.
-----------------------------------------------------------------------------------
Journal of Prosthodontics ; 2008, Volume 17: 345-347
Editorial : Inconvenient truths by George Zarb,DDS ( Dr Zarb is one of the pioneers of the field of implantology)
“The integrity of purpose and scientific rigor that characterized the original osseo-integration clinical research has been largely discarded as passe’.”
“Partnership with commercial enterprise now dominate continuing education.”
“New lecture circuit celebrities keep being recruited to promote osseo-integration's newer and expanded promises, albeit it falls significantly outside the technique’s initial oral ecological context.”
“We risk overlooking safety, simplicity and prudence in our clinical judgment.”
“The risk of yet another anarchic phase in treatment decision making has resurfaced."
---------------------------------------------------------------------------------
I think these statements speak for themselves.
I welcome your comments.
Robert Salehrabi,DDS