Decision making for compromised teeth involving the choice between endodontic treatment and tooth extraction followed by an implant-supported prosthesis is challenging. However, systematic reviews examining studies using the same patients or clinical settings to provide conclusive evidence regarding the best approach are lacking. The purpose of this systematic review was to compare the survival rate, complications, failure, and patient-reported outcomes of endodontically treated teeth and implant-supported prostheses. After the protocol had been registered at the International Prospective Register of Systematic Reviews (PROSPERO), PubMed, Scopus, and the Cochrane Database of Systematic Reviews were searched from database inception to July 2023 with no language restriction. A manual literature search was performed. The review protocol was based on the population, intervention, comparator, outcome, and study design (PICOS) criteria and included all observational and experimental human studies that directly compared the survival, complications, and patient-reported outcomes of teeth with pulpal and periapical disease after all types of endodontic treatment and subsequent restoration and tooth extraction followed by an implant-supported prosthesis. The risk of bias of the included studies was assessed by using the modified Newcastle-Ottawa scale. Eight observational studies were included in this systematic review: 3 retrospective cohort and 5 case-control studies. Three included studies revealed no difference in survival rate between endodontically treated teeth and implant-supported prostheses during the first 3 years, but the survival of endodontically treated teeth declined over time with a higher failure rate than implant-supported prostheses. In contrast, the other 3 included studies reported lower survival rate for implant-supported prostheses and more complications. In terms of patient-reported outcomes, patients were generally satisfied with both treatment modalities, with notable improvements in oral health-related quality of life in those receiving endodontic treatment. Whether implant-supported prostheses or endodontically treated teeth are better in terms of survival outcome is unclear. Improved oral health-related quality of life was found after endodontic treatment.

中文翻译：

---

根管治疗牙齿与牙种植体支持修复体的生存率、并发症和患者报告的结果：系统评价

对于受损牙齿的决策，涉及在牙髓治疗和拔牙之间进行选择，然后使用种植体支持的修复体，这是具有挑战性的。然而，缺乏使用相同患者或临床环境进行研究的系统评价，以提供有关最佳方法的结论性证据。本系统评价的目的是比较经过牙髓治疗的牙齿和种植体支持的修复体的存活率、并发症、失败和患者报告的结果。该方案在国际系统评价前瞻性登记册 (PROSPERO) 注册后，从数据库建立到 2023 年 7 月，对 PubMed、Scopus 和 Cochrane 系统评价数据库进行了检索，没有语言限制。进行了手动文献检索。审查方案基于人群、干预、比较、结果和研究设计 (PICOS) 标准，包括所有观察性和实验性人体研究，直接比较患有牙髓和根尖周疾病的牙齿的生存率、并发症和患者报告的结果在所有类型的牙髓治疗以及随后的修复和拔牙之后，再进行种植体支持的修复体。使用改良的纽卡斯尔-渥太华量表评估纳入研究的偏倚风险。本系统评价纳入了 8 项观察性研究：3 项回顾性队列研究和 5 项病例对照研究。纳入的三项研究显示，在前 3 年中，经过牙髓治疗的牙齿和种植体支持的修复体之间的存活率没有差异，但经过牙髓治疗的牙齿的存活率随着时间的推移而下降，失败率高于种植体支持的修复体。相比之下，其他 3 项纳入的研究报告种植体支持的假体存活率较低且并发症较多。就患者报告的结果而言，患者普遍对两种治疗方式感到满意，接受牙髓治疗的患者口腔健康相关的生活质量显着改善。就生存结果而言，种植体支持的修复体还是经过牙髓治疗的牙齿是否更好尚不清楚。牙髓治疗后发现口腔健康相关的生活质量得到改善。