ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title Comparison Of Endodontic And Fixed Partial Denture Treatment
Clinical Question In a patient with caries in the pulp of a tooth, will root canal treatment as compared with extraction followed by a fixed partial prosthesis be more successful over the lifespan of the patient?
Clinical Bottom Line Long-term survival rates for root canal therapy were similar and superior to those for fixed partial dentures. Patients that received root canal therapy also had a more positive self image than those that received fixed partial dentures. (See Comments on the CAT below)
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 17936128Torabinejad/2007 Patients with fixed partial denture treatment or root canal therapySystematic Review
Key resultsIn patients with periodontally sound teeth that have pulpal and/or periradicular pathosis, root canal treatments had superior 6+-year weighted survival compared to replacement using fixed partial dentures. For patients with periodontally sound teeth that have pulpal and/or periradicular pathosis, endodontic, and fixed prosthodontic treatments had superior psychosocial outcomes, primarily with respect to patient self-image, compared to extraction without replacement or with replacement using a fixed partial denture.
Evidence Search Search “Fixed Partial Denture Survival” AND “Root Canal” ...view in PubMed
Comments on
The Evidence
Being a systematic review, the study demonstrated searches performed in MEDLINE, Cochrane, and EMBASE databases were enriched by hand searches, citation mining, and expert recommendation and included 143 selected studies. Few individual studies have directly compared these treatments.
Applicability Based on the evidence, the clinician can take into account the long term survival of the two different procedures along with their psychosocial outcomes to determine a treatment plan.
Specialty/Discipline (Endodontics) (General Dentistry) (Prosthodontics)
Keywords Root canal therapy, Fixed partial denture
ID# 779
Date of submission: 03/17/2011spacer
E-mail lealg@livemail.uthscsa.edu
Author Gustavo Leal
Co-author(s)
Co-author(s) e-mail
Faculty mentor/Co-author Adriana Green, DDS, MPH
Faculty mentor/Co-author e-mail greenav@uthscsa.edu
Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?)
post a rationale
None available
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Comments on the CAT
(FOR PRACTICING DENTISTS' and/or FACULTY COMMENTS ON PUBLISHED CATs)
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by James Ball, Mohamed Elnazer (San Antonio, TX) on 08/08/2013
I conducted a PubMed search in August 2013, and was unable to find any new evidence. This CAT effectively answers the question using a high level of evidence, and stresses the importance of maintaining the natural dentition when possible. It is also worth noting that the review compares endodontically treated teeth with single unit implants and shows similar success rates. This is consistent with the findings of newer studies; however, endodontically treated teeth require less interventional therapy and have minimal loss of function compared to implant therapy (Doyle 2006, 17682611 and Hannahan 2008, 18928836 ).
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