A comparison of the success of root resected molars and molar position implants in function in a private practice: Results of up to 15-plus years

Background: When faced with a furcated molar, today's clinician must decide between a number of treatment options, including root resection, tooth rem oval, and implant placement. This paper assesses the results in one private clinical practice of root resection and subsequent restoration or molar im plant placement and subsequent restoration. Clinical considerations in trea tment selection are discussed. Methods: A retrospective analysis of treated patients was carried out by ex amining active and inactive patient charts. When patients had discontinued therapy, every effort was made to determine the reason for leaving the priv ate practice, so as to assess the impact of previously undocumented treatme nt failure on the statistics in question. Results: A total 701 root resected molars and 1,472 molar implants were eva luated after greater than or equal to 15 and 13 years in function, respecti vely. Resection of the distal root of a mandibular molar demonstrated the l owest success rate (75%). All other success rates for various root resected molars in function ranged from 95.2% to 100%. Lone standing implants in se cond molar positions demonstrated the lowest success rate (85%). All other implant use in molar positions demonstrated a success rate ranging from 97. 0% to 98.6%. Root resected molars and molar implants demonstrated the highe st degree of failure when they were lone standing terminal abutments. Seven out of 23 (30.4%) root resected molar failures, and 17 of 45 (37.8%) of th e molar implant failures were associated with untreated parafunction. Cumul ative success rates were 96.8% for root resected molars and 97.0% for molar implants. Success and failure are discussed by tooth and/or implant positi on, and resected root, where applicable. Possible ramifications of these fi ndings upon treatment planning are also reviewed. Conclusions: Both molar root resection and appropriate restoration and mola r implant placement and restoration demonstrated a high degree of success i n function. However, this success rate is markedly affected when either the root resected molar or molar implant is a lone standing terminal abutment. Care must be taken to choose the appropriate treatment modality for a give n patient scenario.