You often hear implant dentists brag about implant success rates as high as 98% – despite the fact  that such numbers just don’t jibe with reality. The reality is much more modest (and non-industry funded).
And as we noted before , this is partly because implants are often placed into the diseased tissue. After all, tooth loss commonly results from deep, chronic decay or severe gum disease. The disease doesn’t just go away once a tooth has been pulled.
A 2015 study recapped  in the latest issue of Evidence-Based Dentistry offers some perspective.
For the study , researchers reviewed two dozen studies on implant success with respect to periodontal health. Unsurprisingly, patients with healthy gums had better results with the implants than those who had been treated for periodontitis.
Implant success and survival were higher in periodontally healthy patients, whilst bone loss and incidence of peri-implantitis was increased in patients with history of treated periodontitis. There was a higher tendency for implant loss and biological complications in patients previously presenting with severe forms of periodontitis.
The reported survival rate for implants among the gum disease-free group ranged from 91.67 to 100%. For those with severe gum disease, it dropped as low as 79.22% over a 1.2 to 16 year follow-up.
So all the better that, when given a choice, most folks opt against them – as shown in a new study  in the BDJ. Given a choice between “saving” a tooth via root canal therapy or having the tooth extracted and replaced with an implant, more than three-quarters of respondents opted for the more conservative treatment.
Of course, root canals present their own problems that need to be addressed. You have to wonder how numbers might change if patients were given the facts about root canal risks  and offered a third option: extraction and replacement with a bridge or partial. (Yes, one-tooth “pop-in” partials are a possibility.)
Even so, it’s interesting to note that the popular preference jibes with what earlier research has shown : at-risk teeth that are adequately treated last longer than implants, too. So why rush to implants?