(A systematic review of long-term tooth and implant survival rates)

This systemic review by Levin and Halperin-Sternfeld compared the long-term survival of natural and compromised (but otherwise well maintained) teeth with dental implants in studies that had at least 15 years of follow-up. A total of nineteen articles were included: nine in the tooth survival, ten in the implant survival category. Natural teeth had a width of annual loss between 3.6 and 13.4 over the long term (≥15 years), and implants showed a wider range from 0 to 33%. The heterogeneity across the studies made pooling of the evidence in favor of a meta-analysis impossible. However, the data demonstrate that dental implants do not necessarily achieve better survival results than natural teeth, the latter of which might be appropriately treated and regularly attended to.

It is concluded by the authors that the decision to extract a compromised tooth in favor of implant placement be made cautiously. While implants are reliable replacements, they are associated with surgery and the surgery is irreversible. Therefore, whenever possible, it may be possible to preserve a natural tooth for a similar lifespan without needing more extensive treatment.