DTUK1210

May 3-9, 201024 United Kingdom EditionEducation F or most patients, the best implant is a natural tooth, so maintaining a patient’s natural teeth is one of the main benefits of endodontic treatment over implant surgery. Endodontic success is cur- rently defined in the terms of the retention of a symptom-free tooth, which should require no further immediate treatment. The typical success rate of an en- dodontic procedure now ranges from 65 per cent to 95 per cent, depending on whether the pro- cedure is carried out on a pre- viously treated tooth or a vital, non-infected tooth. Implant success, however, is determined in terms of survival, a potentially misleading phrase – the mere presence of a tooth or implant should not be perceived as a triumph. After all, if a patient requires time-consuming and potentially uncomfortable post- surgery treatment, the initial procedure can hardly be deemed a success. It was commonly believed that for patients who have chosen an implant over and above endo- dontic treatment, the completion of the surgery was the end of the story. However, implant special- ists are now seeing examples of late failures, as well as patients suffering from problems with the implant’s prosthetic component. Priority: patient care It is difficult to determine which procedure is the most success- ful. As healthcare professionals, our priority must be the patient, and working towards providing the best patient care possible should be the main objective. Bearing this in mind, I am aware that the most favourable option for the patient is usually to have the quickest treatment, minimis- ing the hours spent in the den- tist’s chair. The time involved in placement of an implant, as well as the potential subsequent ap- pointments increases the treat- ment time for the patient. Im- plants are not just “popped in”, but are instead a very complicat- ed, time-consuming and expen- sive treatment modality. Recent indications from peri- odontists reveal that non-surgi- cal periodontal treatment, even if further endodontic treatment is required, is preferable to im- plants as it helps save the origi- nal tooth, without the need for invasive procedures. We all endeavour to offer to- tal patient care, and for most patients, maintaining their own teeth is of the highest priority. However, we do have to be aware that there is not always the op- tion to save the tooth, and in this situation there is an undeniable argument for the provision of implants. However, a full-case as- sessment needs to be undertaken before any treatment is planned, and I would recommend a com- prehensive discussion of the mer- its of a bridge vs an implant is a good idea. Also, the patient must of course be made aware and un- derstand the full treatment proc- ess, and give full consent. Effective communication Maintaining a good professi- onal dialogue with referral prac- tices is key to providing patients with optimum patient care and honest advice. Building and maintaining relationships with periodontal, restorative, ortho- dontic and endodonic specialists enables referring dentists to be- come involved in both the plan- ning and treatment stages of a patients’ procedure. DT Dr Michael Sultan weighs up the pros and cons of endodontic treatment over implants Endov implants About the author Dr Michael Sultan BDS MSc DFO is a special- ist in Endodontics and the clinical director of EndoCare. To talk to a member of the Endocare team call 020 7224 0999 or email reception@en- docare.co.uk or for more information please visit www.endocare.co.uk.