Root Canal vs. Dental Implants: Is The Evidence Truly Compelling?

I think it all depends on the standard of care of individual clinician. If one does it right at high standard, it is not a matter of which option is superior, but a judgement on a case by case basis, on which is the preferred option to the patient and clinician. And I believe the successful rate of implant prosthetics is going to be ever higher and that its complications ever less with the advancement of technologies, and so is true for endodontics. I do not think we can simply draw a general comment on which is the better option. For the mean time, if everything being equal, the cost difference and considerations relevant to the implications of the implant surgery, may be the prime determinants of the ultimate choice.

The problems is the use of dental implants for everything. Some tooth that can be treated it's been extract to put implants.
If you have a serious problem in your knee, do ypu like to put out your leg and get a brand new protesis or are you like to preserve your leg? Don't do it with your's patients tooth. If they have a tradicional treatment do it.
Think Big.

It's funny how you hear from endodontists that root canal treatment with a optimal result lasts a life timeand then implantologists that implant lasts a life time ,and yet you see and hear about failing root canal and implants quite often.
Is that purely due to fault of doctors with not enough training and exposure?
Probably at least part of the reason is. But what about those studies came out in late 80s and 90s about average longevity of root canal treatment that are done on infection controlled environment? That being 15 years( some other studies suggested 12 to 18 years), that's being a bit short of life time, wouldn't you think? Maybe it is if the patient who get the treatment is very old and expected to expire within next 10 years. I did extensive reaserch on various implant systems in dental school as an asistant to implantologist at the school. Although it's been a while, I don't see any other studies stating there's a higher success rate now with implants. I tell patients beore they make up their mind, that nothing here in dental office we do last forever. At least that's an honest statement.

I re-read the paper now that the AAE was making such a big deal out of it. It a comparitive study of a perio practice and and endo practice. Each pulled about 140 charts randomly and looked at success and outcomes over 3-5 years. My main concern was that we were comparing initial endo therapy to implant therapy, which anyone would hopefully agree have the same outcome. They actually included endodontic retreatements in the study which was very respectible but did not say how many retreatments were in the study. The implant vs endo discussion has to compare retreatment success to implant success to really provide guidance for treatment planning decisions, but even if endo retreatment is less predictable when you have a failed endo you at least have something you can work with in terms of bone which is not the same for implants. They also looked at implant interventions but they did not catergorize the implant complications and give any insight to what types of problems that had. I buy into the idea that properly restored endodontic therapy done by a specialist has the a very good long term prognosis. Many people who think endo is unpredictable are the ones that are only treating the ones that fail with implants - no the ones that are successful. Think about it - was a periodontist ever referred a tooth with successful RCT for replacement? I have sat through so many implant lectures where a speaker shows case after case of failed implants where a trained endo eye sees gross errors (missed canals, short fills, etc) and the speaker replaced all these teeth with implants.