Dental implants or endodontics? The valuation of the experts is fundamental
One of the principles of dentistry consists, whenever possible, in conserving natural teeth. And it is that science, despite its longing to imitate or overcome nature, which has yet to invent a solution capable of improving the functionality and strength of healthy natural teeth.
However, there are situations where there is no other remedy than extraction. When this happens, the best solution that exists so far is the placement of dental implants, as long as the conditions of the patient allow it. However, there are cases in which the diagnosis can generate controversy.
When a tooth is fractured or has undergone a deep caries exposing the dentin, there is a treatment that seeks precisely to save the tooth: the endodontia, which consists in removing the pulp, the soft tissue that is inside the tooth and that includes the vessels and nerves; to later seal the ducts and rebuild the crown. This treatment, according to the Spanish Association of Endodontics (AEDE), “allows to maintain the natural dentition, the bone and the gum that surrounds it, as well as its functionality.” That is to say, to save the natural tooth.
AEDE indicates that there are only three contra-indications to save a tooth through endodontics: the presence of a vertical fracture, an unfavourable ratio between the crown and the root or insufficient periodontal support.
“They are the only cases where the alternative to endodontics should be valued,” says the Association. However, the percentage of success between an implant treatment or endodontics produces very similar results. According to a study published in the Dental Gazette, one of the most prestigious newspapers in the sector, “implantology has recently advanced with new designs and the success rate reaches up to 97% depending on the location of the dental bow and the density of the bone . Success means a strong integration of the implant into the bone. This success rate is similar to conventional endodontics, above 95%, and from eight to ten years and even 100%. Due to the implications of the removal of the tooth, there are therefore two very variable options in the treatment plan. “
In Artedental, a clinic specialising in dental implants in Puerto de la Cruz, it is clear that this is a complex decision, and for that reason they count on their equipment with two heavyweights of both disciplines. Víctor Cubillo, medical director of the clinic and implant specialist with a history of more than a decade; and Ruth Pérez Alfayate, Doctor Cum Laude in Dentistry and Professor of the Official Master’s Degree in Advanced Endodontics at the European University of Madrid.
Dr. Pérez Alfayate, who has just presented at the National Congress of Endodontics in Malaga, his paper “Root Reabsorption: Diagnosis, Classification and Treatment Options” with Montse Mercade, explains that the assessment of the experts is essential for each case.
“The conditions of each patient should be carefully evaluated to determine the best treatment. In Artedental we evaluate each case as a unique one, and the experts of each specialty we determine together what is the best solution considering the cost, the effectiveness and the long term result, ” he says.
Dr. Cubillo, on his part, is aware of the value of maintaining the tooth, but also of the exponential advancement of dental implants in recent decades. “Improving the quality of life of many patients thanks to the dental implants is impressive. There is no need to give a case for lost, and while the endodontia allows to maintain the natural tooth, for whom this treatment is not possible, there is a very similar solution regarding functionality and aesthetics that has come to stay, ” he says.
But we must not forget the most important question before a patient experiences any ailment, and it is prevention. “If you go to the dentist once a year, any problem can be detected early, avoiding for example, in the case of an advanced caries, endodontics or extraction,” concludes the medical director of Arte-dental.