Abstract
The decision between preserving a tooth through contemporary endodontic treatment or extracting and replacing it with an implant- supported restoration remains one of the most debated topics in restorative dentistry. Therefore, it is of interest to compare long- term outcomes of endodontic treatment versus implant-supported crowns in 412 teeth from 378 patients over 10 years. The Endo group (206 teeth) received root canal treatment; the Implant group (206 teeth) had extraction and single implant placement. Strict success criteria assessed PAHI ≤1 for endodontics and minimal bone loss without complications for implants. At 10 years, success rates were 91.3% (Endo) versus 89.8% (Implant) (p=0.587); survival rates were 94.7% versus 97.1% (p=0.221). This advances knowledge by demonstrating equivalent long-term success of modern endodontics and implants when controlling periodontal health, informing tooth preservation decisions in restorative dentistry.