title: Tooth retention through endodontic microsurgery or tooth replacement using single implants: a systematic review of treatment outcomes.
abstract: BACKGROUND
  Clinicians are regularly confronted with difficult choices. Should a tooth that has not healed through nonsurgical root canal treatment be treated through endodontic microsurgery or be replaced using a single implant? Acquiring complete, unbiased information to help clinicians and their patients make these choices requires a systematic review of the literature on treatment outcomes. The purpose of this systematic review was to compare the outcomes of tooth retention through endodontic microsurgery to tooth replacement using an implant supported single crown.
  
  
  METHODS
  Searches performed in PubMed, Cochrane Library, Web of Science, and EMBASE databases were enriched by citation mining. Inclusion criteria were defined. Sentinel articles were identified and included in the final selection of studies. Weighted survival and success rates for single implants and endodontic microsurgery were calculated.
  
  
  RESULTS
  The quality of the articles reporting on single implants and endodontic microsurgery was moderate. Data for single implants were much more plentiful than for endodontic microsurgery, but the endodontic microsurgery studies had a slightly higher quality rating. Single implants and endodontic microsurgery were not directly compared in the literature. Outcomes criteria were often unclear. At 4-6 years, single implants had higher survival rates than teeth treated with endodontic microsurgery. Qualitatively different success criteria precluded valid comparison of success rates.
  
  
  CONCLUSIONS
  Survival rates for single implants and endodontic microsurgery were both high (higher for single implants). Appraisal was limited by a lack of direct treatment comparisons. Long-term studies with a broad range of carefully defined outcomes criteria are needed.
authors.affiliation: Advanced Endodontics, School of Dentistry, Loma Linda University, Loma Linda, California. Electronic address: mtorabinejad@llu.edu.
authors.forename: Mahmoud
authors.initials: M
authors.lastname: Torabinejad
authors.affiliation: Advanced Periodontics, School of Dentistry, Loma Linda University, Loma Linda, California.
authors.forename: Maria
authors.initials: M
authors.lastname: Landaez
authors.affiliation: Advanced Endodontics, School of Dentistry, Loma Linda University, Loma Linda, California.
authors.forename: Marites
authors.initials: M
authors.lastname: Milan
authors.affiliation: Advanced Periodontics, School of Dentistry, Loma Linda University, Loma Linda, California.
authors.forename: Chun Xiao
authors.initials: CX
authors.lastname: Sun
authors.affiliation: Advanced Periodontics, School of Dentistry, Loma Linda University, Loma Linda, California.
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Henkin
authors.affiliation: Implant Dentistry, School of Dentistry, Loma Linda University, Loma Linda, California.
authors.forename: Aladdin
authors.initials: A
authors.lastname: Al-Ardah
authors.affiliation: Advanced Prosthodontics, School of Dentistry, Loma Linda University, Loma Linda, California.
authors.forename: Mathew
authors.initials: M
authors.lastname: Kattadiyil
authors.affiliation: School of Public Health, School of Dentistry, Loma Linda University, Loma Linda, California.
authors.forename: Khaled
authors.initials: K
authors.lastname: Bahjri
authors.affiliation: School of Public Health, School of Dentistry, Loma Linda University, Loma Linda, California.
authors.forename: Salem
authors.initials: S
authors.lastname: Dehom
authors.affiliation: University Libraries, Loma Linda University, Loma Linda, California.
authors.forename: Elisa
authors.initials: E
authors.lastname: Cortez
authors.affiliation: UCLA School of Dentistry, Los Angeles, California.
authors.forename: Shane N
authors.initials: SN
authors.lastname: White
mesh_terms: D003442:Crowns; D019250:Dental Implants, Single-Tooth; D019094:Dental Prosthesis, Implant-Supported; D006801:Humans; D008866:Microsurgery / Q000379:methods*; D012390:Root Canal Therapy / Q000379:methods*; D014081:Tooth Extraction; D016896:Treatment Outcome
keywords: Endodontic microsurgery; single implants; systematic review