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Quality of life of endodontically treated versus implant treated patients  a university-based qualitative research study
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Quality of life of endodontically treated versus implant treated patients a university-based qualitative research study

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Background: Is it worth saving a tooth with endodontic therapy - or - just extract and place an implant? Success rates btn endodontics and implant therapy are fairly similar, however, they are 2 …

Background: Is it worth saving a tooth with endodontic therapy - or - just extract and place an implant? Success rates btn endodontics and implant therapy are fairly similar, however, they are 2 different modalities of treatment - and - can they really be compared?
Gatten et al. Quality of Life of Endodontically Treated versus Implant Treated Patients: A University-based Qualitative Research Study. J Endod 2011;37:903–909.

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  • 1. Topic: Endodontics and ImplantsBackground: Is it worth saving a tooth with endodontic therapy - or - just extract and place an implant? Successrates btn endodontics and implant therapy are fairly similar, however, they are 2 different modalities of treatment -and - can they really be compared?Gatten et al. Quality of Life of Endodontically Treated versus Implant Treated Patients: A University-basedQualitative Research Study. J Endod 2011;37:903–909.Study involved 48 pers (17 w/ 1 x endodontic tx and 20 w/ 1 x implant). They held discussion groups (3 pers/treatment group) to discuss their quality of life regarding their modality of treatment. Each session consisted of 90mins and the participants received food and drinks. A QOL survey was completed prior to discussions.Inclusion criteria: Patients who received one root canal therapy or a single implant-based rehabilitation, Patientswith a coronal restoration with at least 1 year in occlusal function, Age >18 yrs, and ASA I/II. The overall mean agewas 57. The implant patients included 4 anterior and 16 posterior implants. The endodontically treated patientsincluded 3 anterior and 14 posterior treated teeth.Some key discussion points:Financial Implications of Procedure/Cost of Treatment - The financial aspect and cost of dental treatments guidespeople in their treatment decisions. Most participants in both groups felt that the cost of their respectivetreatment was expensive. Many chose to go to a dental school b/c tx was cheaper. The issue of cost came up asthe rationale to protect the implant or clean it better, or led to the feeling ‘‘they had better hold on to it for a longtime.’ ’Insurance Coverage Whether a treatment is covered by insurance or not plays a key role whether patients willget a certain dental treatment. Almost all participants that have dental insurance in the implant group stated thattheir insurance does not cover the cost of an implant.Additional Costs Several participants from both groups mentioned that they were surprised about additionalcosts on top of the initial price quoted to them for their implant or root canal. (Crown in root canal cases)Physical Pain of Procedure. Although most individuals in the implant group agree that there is only minor painduring the procedure, an overwhelming number of participants stated that the worst pain of the whole procedurewas the extraction of the tooth before implant placement. Some participants in the endodontic treatmentcategory stated having sensation during the procedure but no pain.Length of TX Mouth in Chair Process.Implants: Within the implant groups, there was a common complaint of how long it took to get everythingcompleted, including the crown placement. Most participants recall at least a 3-6 month gap between the time ofimplant placement and receiving their crown. Overall, the consensus was that participants felt the overall processtook a long time. However, it seems that patients are happier when they know what to expect beforehand.Endodontic Groups: The most common complaint was the time they had to spend with their mouth open. Oneparticipant commented ‘‘The only thing I think that I didn’t feel very comfortable about, you have to keep yourmouth open for a while.’ ’Psychological Discomfort. Many individuals in the implant group mentioned trying to protect the implant or beingmore careful with it because of its cost or because they are afraid they might break it or lose it. Others mentionthat it feels different or looks different, but it might just be psychological. Some individuals who had bone graftingmentioned the fact that the bone was from a pig or cow. They did not like the thought of having animal or foreignmaterial in them.With any treatment, there is a psychological aspect to consider. Addressing this, one endodontic participantstated, ‘‘It’s really important for me to keep my teeth. It always has been. It’s kind of a combination of things, thepsychological aspect; these are body parts of mine I’ve had my whole life. I’m kind of attached to them, and there’sthe emotional side too. I wouldn’t want to lose a finger or a toe if I could help it.’ ’ Others commented that theyfeel more confident now that they saved their tooth and smile more. Some stated they were glad to have theinfection or abscess gone.

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