Endodontic Treatment versus Implant Placement for Compromised Teeth: Decision-Making Trends in Saudi Arabia

Rayan Bahabri1, 3, *, Sary Borzangy2, Nevine Taymour3, 4, Abdulrahman Maddhar1, Mahmod Alkayyal1, Walaa Alhazmi1, Sarah Taher1
1 Taibah University Dental College and Hospital, Al-Madinah Al-Munawarah 42353, Saudi Arabia
2 Department of Substitutive Dental Sciences, Taibah University Dental College and Hospital, Al-Madinah Al-Munawarah 42353, Saudi Arabia
3 Department of Restorative Dental Sciences, Taibah University Dental College and Hospital, Al-Madinah Al-Munawarah 42353, Saudi Arabia
4 Alexandria University, Alexandria, Egypt

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© 2021 Bahabri et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Taibah University Dental College and Hospital, Al-Madinah Al-Munawarah, 42353, Saudi Arabia; E-mail:



The decision to save a compromised tooth is a major challenge among dentists and may vary among those with different areas of specialization.


The objective of this study was to determine the influencing factors that play a role in decision-making trends when choosing whether or not to save a compromised tooth, either through endodontic treatment or extraction and implant placement.


In this cross-sectional study, a questionnaire was administered to a convenience sample to assess decision-making within different dental specialties among various dental schools in Saudi Arabia. Participants were stratified into four groups based on clinical specialties, including endodontists (n = 45, 23.9%), periodontists (n = 51, 27.1%), prosthodontists (n = 55, 29.3%), and oral and maxillofacial surgeons (n = 37, 19.7%). The data of 188 participants were analyzed using Chi-square tests, with significance at p ≤ 0.05.


Endodontists were significantly more likely than other specialists (p ≤ 0.002) to decide to retain a compromised tooth rather than place an implant. In difficult prosthetic cases, faculty surgeons were significantly more likely to place an implant than other specialists (p ≤ 0.01).


The assessment of decision-making trends demonstrated that retention of the natural tooth by endodontic and restorative treatments was preferred over extraction and implant placement. Increased prosthetic complexity shifted this preference towards implant placement. This study provides a basis to help identify factors contributing to decision-making among dental professionals; these factors could improve existing guidelines to ensure a successful practice.

Keywords: Decision-making, Endodontist, Evidence-based practice, Prognosis, Prostheses, Implants.