Monday, February 16, 2009

Longevity of dental implants vs. natural teeth

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.”

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


Anonymous said...

I agree that the excessive marketing by dental implant companies have given the general public the false idea that implants are the "cure-for-all". I see it all the time where patients are probably not given all the available options by general dentists in the treatment of missing teeth. As an orthodontist, with the use of TADS, we can often eliminate if not limit the number of implants a patient needs. "Natural Teeth:" There is no substitute.

Anonymous said...

I have been saying this for some time too. I always tell patients that "if it were me, I would do everything I could to SAVE the tooth vs. having it extracted. Even if the short term prognosis is guarded. Good article

mjscottlanyard said...

Natural teeth's longevity is depend on how you taking care of your teeth if you do a proper dental hygiene it is possible that your teeth will last for a long time, while dental implants needs the same and of course it needs a monthly check up just to make sure that your implant was good and to avoid infections.

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girish said...

Yes I also agree that saving a natural tooth by endo or perio prosedure is a better option than extracting & placing implants really good artical & discussion

Dentist Richmond Hill said...

It is true that dental have been promoted as the solution to all dental problems. However, there they are not a true substitute for natural teeth in my opinion.

Farrahfawcett said...

yes, i agree with your all comments. I could to SAVE the tooth vs. having it extracted. Even if the short term prognosis is guarded. Good article.

Online Dental Clinic

Dental Implants said...

Nice article. You opened my eyes. I was going in for implants without exploring all options to save my teeth. Now, I am going to ask for other options before going in for dental implants.

Cosmetic Dentists said...

Very well said. It is always best to look at all available options before having implants. After all, nothing does beat the real thing. Hence, we should all be more disciplined with our oral and dental hygiene. Cheers!

Rockon said...

Yes I also agree that dental have been promoted as the solution to all dental problem.

john said...

yes, it is always recommended to save your natural teeth as there is nothing alternative to natural things.Truly speaking the longevity of natural teeth depends on the care of the teeth.The more you take care, the more it will give fruit.But once the natural teeth has gone the best option is dental implants and the same matter comes, the more you take care, the more it will give fruit but it is better to take care of your natural teeth as it will give more longevity if one can take care of it, to its best.

Hygienist Salary said...

Thanks for the information..
I have a friend who just got a tooth pulled out and she heard from someone that one dental implant takes two years off of your life. Now she is scared to get the implant! Can anyone tell me if this is real or fake so I can make her feel better about getting the implant. Thank you so much!

The Endo Blog said...

Hygienist Salary,

No I have never seen any evidence to indicate an implant would have that effect on longevity. That sounds ridiculous. I would not hesitate to have an implant to replace one of my own missing teeth.

Dr. Sarkis Nalbandian said...

Dear Robert Salehrabi,

I totally agree with your comments and the evidence that is presented.

My biggest problem is relaying this to my referring dentists that "this tooth can be saved".

Unfortunately commercial institutions are targeting at general practitioners with little experience in long-term planning and prognosis at patient and individual tooth level.

This results in excessive number tooth removal, especially when planning fixed full arch cases, where unnecessary sound teeth are removed for the sake of "long term success"

The problem as we all see is the motivation of financial success, as many "practice marketers" preach for dentists to consider implant therapy as a growth production in their practice.

Incorrect information: diagnosis and treatment planning can result in unnecessary tooth loss.

A the end of the day ultimate looser is the patient.
There are no treatment for peri-implantitis.


Dr. Sarkis Nalbandian
Sydney - Australia
B.D.S. (Hons.) Dip. Clin. Dent. (Oral Implants)Uni.Syd.
M.Clin.Dent (Prosthodontics) King’s College Uni.London

Prosthodontics and Implant Surgery

Dental Surgeon PA said...

In my own opinion dental implants is not necessary if your teeth/tooth can be save. It's better to have natural teeth than artificial teeth though.

Nonetheless, if your teeth/tooth can no longer be save then that's the time the idea of having dental implant comes in.

Unknown said...

Truly speaking the longevity of natural teeth depends on the care of the teeth.Unfortunately commercial institutions are targeting at general practitioners with little experience in long-term planning and prognosis at patient and individual tooth level.

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Dental Implants said...

I think that because there is such demand for dental implants and the margin is so good, these adverts are always going to be here. But I also think that dental implants are a great treatment option so I can't fault all of these practices for offering the service.


Brisbane dentist said...

The research has a point but I both work same for me. Though dental implants just need to be checked often, but, it's still important that you have the real tooth and taking care of it, at an early age will avoid destruction of teeth as you grow old.

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SEO said...

Great article, Dental Implants

Orthodontist Saugus MA said...

Great Blog!! That was amazing. Your thought processing is wonderful. The way you tell the thing is awesome. You are really a master.

Orthodontist Saugus MA

Implantes Dentales said...

agree that the excessive marketing by dental implant companies have given the general public the false idea that implants are the "cure-for-all". I see it all the time

dentist Bondi Junction dental implants said...

Agreed! Dental implants will never surpass natural teeth, but we also need to encourage people to stay healthy and with regular check up with their respective dentists to attain natural white and shiny teeth.

Dental Implants said...

Hey...really great points are presented by you here. I was also searching such content since a long time and at last I found it here. I hope you will come more update in future too.

Claire said...

Implants generally will last between 20 to 25 years, or even longer, depending on the location of the implant, the patient's overall health, both at the time of placing the implant and their ongoing health status, and the patient's compliance with oral hygiene and routine dental visits. Because back teeth receive more stress and wear from chewing, implants in the back of the mouth typically will not last as long as implants located at the front of the mouth. The type of dental implants used by the Doctors India, have recently been documented to have a greater than 95% success rate over an initial period of 15 years.  We can anticipate this type of success going beyond 15 to 20, and even 25+ years.

Dental implants said...

It is true that dental implants have been publicized as the remedy to all dental issues. However, there they are not a real alternative for natural tooth in my view.

Unknown said...

Good advice for dental care. Thanks for sharing this valuable article with us.

Amandeep Goma said...

Dental implants are intimately connected with the gum tissues and underlying bone in the mouth. Since periodontists are the dental experts who specialize in precisely these areas, they are ideal members of your dental implant team. Not only do periodontists have experience working with other dental professionals, they also have the special knowledge, training and facilities that you need to have teeth that look and feel just like your own. Your dentist and periodontist will work together to make your dreams come true.