Endodontic treatment versus dental implant - Ethical considerations

I. M. Gheorghiu, P. Perlea, I. Suciu, A. N. Temelcea, C. Stefanescu

Abstract: In modern society, bioethics is an indispensable element of medical practice, regardless of the clinical specialty. A conservative approach to dental treatment on teeth with a chronic pathology in the apical territory versus extraction, followed by the insertion of a dental implant and prosthetic restoration is a topical issue has significant ethical consequences, not only purely medical. Each clinical case is unique, and the decision to perform either endodontic treatments or dental implants is important in terms of the irreversible consequences of tooth loss. In making a therapeutic decision regarding an endodontic treatment or a prosthetic implant treatment there are multiple factors involved, starting from complete and thorough clinical evaluation and imaging, local and loco- regional assessment of general health status, tooth value on the dental arches, prognosis for each therapeutic modality. Equally important are the ethical aspects of dental treatment such as the need for adjacent surgical interventions with additional risks and costs to the patient. Today it is considered that endodontic treatment and even retreatment should be the first choice in most clinical cases, except when the tooth is thought to be irrecuperable, when implant therapy is the optimal choice. The entire decisional and therapeutic process is approached on medical scientific basis, taking into account the patient's supreme good, as a fundamental value of medical ethics, and should be based entirely on medical and never on financial reasoning.
Keywords: endodontic treatment, dental implant, therapeutic decision, long-term prognosis, bioethical principles.