5-year Survival Analysis of Implants Versus Root Canals

Objectives: To determine if there is a difference in the survival of implant and root canal treatments completed in a dental school setting over a 5-year time period
Methods: This was an IRB approved retrospective study of implant and root canal (RCT) survival using existing data. We identified patients who received either or both treatments in 2005-2006 followed them for three years after placement. Patient records (physical and electronic) were used to collect information on patient age, insurance, gender, medical conditions, type of tooth (anterior, premolar and molar) and treatment. Survival was defined as when the tooth or implant was in the mouth and did not require a retreatment, surgery, or removal. Data were double entered, cleaned, and cross referenced as needed to ensure accuracy. Simple and multivariable regression modeled survival at 1, 2 and 3 years by treatment type.
Results: A total of 568 implants and 688 RCT were completed on 788 patients. The 1, 2, and 3 year survival rates for RCT were 95.64%, 93.46%, 92.15%; for implants survival rates were 97.59%, 97.22%, 91.28%. At 1 year there was a borderline difference in the survival of implants compared to RCT (p=0.0655). At two years there was a significant difference in survival in favor of implants versus RCT; p =0.0025. At 3 years there was no significant difference in survival of implants versus RCT. At 3 years, being on Medicaid, number of medications, and number of RCT were significant covariates for lowering survival rates for RCT. At 3 years, number of medications increased the survival of implants and history of arthritis/joint pain were significant covariates for lowering implant survival rates.
Conclusions: There was a borderline difference in survival favoring implants at 1 year, a significant difference in favor of implant survival at 2 years, and no difference between either treatment at 3 years.