It is well documented that dental implants comes with long-term success rate including the immediate dental implants and same day teeth. Similarly, keeping teeth with moderate to advanced bone loss via various periodontal/gum treatment methods has enjoyed similar to higher long-term success rates.
The implant dentist specialist often build his/her decision based on clinical experience and familiarity with the treatment options when making such a decision.
A relatively new concept, however, that should be incorporated into this decision matrix is the long-term COST effectiveness to the patient when comparing treatment modalities.
A nice publication by Dr Scott Froum & Kyle L. Summerford tackled this issue in a recent paper with the following summary:
Typical gum treatment for patients with moderate to advanced disease when first presenting to a dental office can consist of quadrant scaling and root planing, osseous surgery with or without regenerative therapy (bone graft), and supportive periodontal maintenance at specific intervals…
In a small subset of the population (less than 5%), periodontal/gum disease can reoccur after treatment, excluding those patients who demonstrate blatant noncompliance with home care, and treatment will have to be rendered again, increasing the overall costs of this type of therapy.
Although dental implants have typically enjoyed high long-term survival rates, their associated initial financial impact is much higher than that of saving the natural dentition. Conservative valuations place start-up costs for implant treatment around two to three times higher than saving natural dentition via gum therapy. In addition, implants are not without complications, and both biologic and/or mechanical complications can be associated with additional treatment costs to the patient. Recently, the literature has been replete with discussion of biologic complications in the form of peri-implant disease. Peri-implant diseases fall into two categories: peri-implant mucositis and peri-implantitis…
Clinical treatment of this disease is often determined by severity, but in general often includes flap surgery, bone grafts, membranes, growth factors, and/or soft-tissue grafts. The overall financial impact upon the patient for this type of treatment can be quite high considering the patient was already subject to initial start-up costs of treatment. In addition, maintenance intervals after implant therapy should be equal to if not more stringent than those of natural teeth…
In conclusion, when deciding between saving the natural dentition and extracting and placing implants, there are many factors to consider. In addition to long-term success rates, the implant specialist and the patient need to consider the long-term economic impact the patient will endure. Both dental implants and periodontal therapy to save natural teeth have high initial success rates with implants usually demonstrating higher start-up costs. However, when looking at long-term retention rates, teeth often demonstrate fewer complications and have less of a financial impact when correction is needed….read more
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