Referring Doctors

Implants

Please allow us to share with you our clinical philosophy on implants. True to our endodontic roots, we fully support the concept, together with the vast majority of the dental profession, that saving natural teeth is most often preferable to extraction and implant placement. However, not all teeth can be saved. Split teeth and vertically root fractured teeth are prime examples of teeth with a hopeless prognosis. Given the advent and high success rate of dental implants these types of hopeless prognosis cases often indicate extraction over any endodontic therapy that can be offered. We readily accept and welcome implants as an alternative. As endodontists, we feel that we can offer a unique perspective on the treatment planning of compromised teeth. We can offer root canal therapy, broken file removal, perforation repair, retreatment, apicoectomy, etc. and have a good handle on which cases are likely to succeed or fail in the short and long term. With the addition of implants to the endodontic armamentarium of available procedures we feel that we can offer a uniquely unbiased and reasonable assessment of the relative value of all of the different treatment options in the many different clinical situations that exist.

“Failure of root canal therapy” is most often the result of recontamination of the root canal system as a direct result of the patient failing to have a permanent restoration placed in a timely manner or as a result of recontamination secondary to new caries. Extraction and implant placement in that scenario is rarely, if ever, indicated. As endodontists, we do not so much hope to make implants a large percentage of our practice as we hope that we will continue to be involved in the treatment planning of compromised teeth.

When it becomes apparent that a tooth referred for endodontic treatment is non-restorable and that an implant is a good prosthetic option for your patients in our chair we currently (unless otherwise requested by your office) discuss the implant option with the patient and send a detailed letter to your office describing the clinical situation and proposing implant placement at our office and implant restoration at your office. We encourage your patients to discuss all of their prosthetic options with you prior to proceeding with any implant placement. We use a model based, stint-guided system for precision implant placement to guarantee the correct position, angulation, and trajectory of the implant for ease of restoration in every case. We can place just the implant and healing abutment or, at your option, we can place a custom abutment on the implant so that when the case comes back to you there is a tooth-colored, prepared abutment ready to take an impression for the crown. Or, if it is your preference, we can simply promote consideration of the implant option and recommend that they visit your office (or another specialists office, if that is your preference) for surgical placement and/or restoration of that implant.

We have found that patients who have been referred for evaluation that end up needing extraction and implant placement find it convenient to avoid going to yet another specialist for that treatment. We would be interested to learn how you would like for us to deal with implant issues regarding patients you choose to refer to our office. Please take a moment to express these preferences, and others, on our
Referring Dentist’s Endo Preferences Sheet. We welcome your input and will put your preferences into action!