Endodontically-Treated Tooth Next to Implant Site: Correct Protocol?

Dr W. asks:

Whenever there is an endodontically-treated tooth next to the dental implant site, I refer the patient to an endodontist to evaluate the endo tooth and to determine if retreatment or periapical surgery is required prior to placing the dental implant. I do this to make sure that the implant does not develop peri-implantitis from a failing endo tooth. Is the correct treatment protocol? What are you all doing in cases like this?

6 Comments on Endodontically-Treated Tooth Next to Implant Site: Correct Protocol?

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LDS
6/19/2007
USe your discretion. If it looks any bit suspicious, poor fill, possible lesion - th.en refer. But if it looks good it isn't. Keep the implant at least 2mm away from the endo tooth, preferably 3mm.
satish joshi
6/22/2007
LDS is right. There is no need to refer each and every case of implants next to endo treated tooth to endodontist, unless there is obvious signs of failure or poor treatment which include poor restoration over that tooth.Remember coronal leakage is a factor to be considered in failure of endo.and you RESTOARTIVE DENTIST SHOULD BE ABLE TO EVALUATE OLD RESTORATION. Spare your patient from unecessary endo-consultation fee, when there is no need.
Dr. F. Lugo
6/27/2007
Since 1986 I have placed impants next to endodontically treated teeth, very few failed ( normally within the first few weeks ). Failure of some of those implants was due to either undiagnosed or misdiagnosed endo problems of one of the proximal teeth. After the endo retreatment or apico., the second ( replacement )implant did not fail. For years I ( I am a periodontist ) always try to clear any concerns about the endo. needs of the proximal teeth, test vitality in those concerned, this is to reduce the possibility of failure and always explain to the patient the potential of failure. I perform those test within my limited endo expertise, many others I refer to the endodontist or ref. General Dentist. When you ask around, the empirical experince "feeling" is that the failure rate due to such problems probably should be around 1:500 to 1:1,000 chance.
Javier Higuera
7/11/2007
It's correct that an endodontist tests if the endo next to the site of the implant is correct, because the influence of the root cannal is the periapical area. It's very frequent to see infection problems with implants because of endodontic reasons (of the next tooth or of the extracted tooth in the implant site). A disinfected area in the site of the implant and its next area is a must for implant success. Hugs 2 everyone
Dale
7/25/2007
Over kill! If it is a poor endo, than have an endodontist evaluate it. Otherwise, place the implant.
M.N.K.
12/1/2007
I suppose the RCT of teeth adjacent to the implant should be notonly good butalso excellent,Otherwise site of implant should be 3mm away from the endotreated tooth.

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