I asked this on the predental forum, but was thinking I might get a great response on this forum as well. I am interested in becoming an endodontist and was wondering if any of you could give me your opinion on the future of the profession. Thanks!
Is ENDO Dying?
- Thread starter Kobe08
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Endo referalls have fallen off a little since more people are opting for implants, but I always think there will be a place for it and plenty of work.
If the issue is strictly endodontically related, RCT can be quite effective in salvaging and cost effective.
If the issue is more perio related, more often than not people are opting for implants. This is why traditional perio has taken a huge hit and they've had to expand their scope to include implants to avoid extinction.
For a Perio + Endo related issues, it is often more cost effective to do an implant on a younger pt than to do a crown lengthening, RCT, post & crown for ex., and have the tooth fail anyways within 15 yrs and paying for the implant later.
In my opinion, there will always be plenty of work for isolated endo lesions but once there is significant perio involvement as well, these cases are more going for the implant therapy.
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I wouldn't call endo dying, but its certainly not in its prime any more, few things I can think off, most GPs are doing more endo these days because of the economy, even those who never touched a root canal before started doing it to increase their practices production, rotary instrument are very popular now and makes it even easier for GPs to do endo, implant now replacing all these cases with questionable prognosis.
Endo still a good speciality, but expect to handle more of the problem cases like perfs, broken files, retreats, rather than straight forward endo, because GPs now are keeping these cases for themselves, in a nutshell, you have to work much harder to maintain the same level of what endodontist used to make few years ago.
Endo still a good speciality, but expect to handle more of the problem cases like perfs, broken files, retreats, rather than straight forward endo, because GPs now are keeping these cases for themselves, in a nutshell, you have to work much harder to maintain the same level of what endodontist used to make few years ago.
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no. as long as people have teeth there will be endo.
but like previous poster has said expect endo specialty to treat increasingly difficult cases.
if perio is the problem how would an implant hold up right?
implant plus a crown still costs more and takes longer to complete.
an endodontic procedure - retreat or apico to save a previously crown'ed tooth is very cost effective and provides quicker resolution of pain.
but like previous poster has said expect endo specialty to treat increasingly difficult cases.
if perio is the problem how would an implant hold up right?
implant plus a crown still costs more and takes longer to complete.
an endodontic procedure - retreat or apico to save a previously crown'ed tooth is very cost effective and provides quicker resolution of pain.
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Cost-effectiveness of Endodontic Molar Retreatment Compared with Fixed Partial Dentures and Single-tooth Implant Alternatives
Sahng G. Kim, DDS, MS, Charles Solomon, DDS
Journal of Endodontics
Volume 37, Issue 3 , Pages 321-325, March 2011
Abstract
Introduction
One of the most challenging situations in dentistry is a failed root canal treatment case. Should a failed root canaltreated tooth be retreated nonsurgically or surgically, or should the tooth be extracted and replaced with an implant-supported restoration or fixed partial denture? These four treatment alternatives were compared from the perspective of cost-effectiveness on the basis of the current best available evidence.
Methods
The costs of the four major treatment modalities were calculated using the national fee averages from the 2009 American Dental Association survey of dental fees. The outcome data of all treatment modalities were retrieved from meta-analyses after electronic and manual searches were undertaken in the database from MEDLINE, Cochrane, ISI Web of Knowledge, and Scopus up to April 2010. The treatment strategy model was built and run with TreeAge decision analysis software (TreeAge Software, Inc, Williamstown, MA).
Results
Endodontic microsurgery was the most cost-effective approach followed by nonsurgical retreatment and crown, then extraction and fixed partial denture, and finally extraction and single implantsupported restoration.
Conclusions
The cost-effectiveness analysis showed that endodontic microsurgery was the most cost-effective among all the treatment modalities for a failed endodontically treated first molar. A single implantsupported restoration, despite its high survival rate, was shown to be the least cost-effective treatment option based on current fees.
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So the article says once the endo has failed, an endo mocrosurgery is less money than an implant?
Well duh...but if you tell a patient that the root canal u did failed, and say the solution is another endodontic procedure...i bet theyre more prone to say go implant
Some would say perio was/is a dying specialty.. So they started placing implants and it has revived their field (almost too much some think.. Never totally leave your roots I say). At my school Endo has started to peak their noses into implants... I'm not saying, I'm just saying. In the end though just pick what you enjoy doing and you'll have more than enough in life I think. Dentistry, for all it's ups and downs, is a kick a** field . Best of luck
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I need to read the article thoroughly to judge, because microsurgery does not sound for me as cost effective as other options
In addition, this article is published by JOE, something you should keep in mind while reading the study (endodontists advertising for endo surgery?)
In addition, this article is published by JOE, something you should keep in mind while reading the study (endodontists advertising for endo surgery?)
T
The QB
As far endo is concerned still there will be enough endos to be done because some patients may wants to save their own natural teeth, and some patients still may count the difference in fees between endo and implant. Many dental insurances do pay for endo but not for implants. And there are patients may not be fit medically for implants or major grafting procedures. There are more stories floating around among patients about complications from implant and grafting surgeries than from endo. Time difference between finishing endo restoration and implant restoration may be an obstacle to some for implants. In my opinion if you like to specialize in endo then you should go for it!
Thanks for all of your input. I know I really won't be able to determine what I want to do until I actually have real experience with these procedures and patients. But it's good to hear all of your opinions and at least plan a little in regards to what I find interesting right now.
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or read a paper from OS or Perio, I wonder what they would say about it.
maybe we should have a neutral source evaluate this debate, like orthodontist. But how often does the ortho see recalls 10 years later?
GP is still the ones referring out endo or implants, and also the ones who do both endo and implants. GP be the ones to offer patients their tx options and make recommendations. They are the ones that will stay with the patients for a long time. Specialists whether it's endo, ortho or os need to kiss GPs butt real good. The more butts they kiss they more referrals they get.
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