{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T10:06:51Z","timestamp":1776161211893,"version":"3.50.1"},"reference-count":26,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T00:00:00Z","timestamp":1776124800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T00:00:00Z","timestamp":1776124800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Prosthodontics"],"abstract":"Abstract<\/jats:title>\n \n Purpose<\/jats:title>\n To compare the long\u2010term survival of nonsurgical endodontic re\u2010treatment versus single\u2010tooth implants and to identify independent demographic, systemic, and lifestyle predictors of failure using a statistical model that accounts for patient\u2010level clustering.<\/jats:p>\n <\/jats:sec>\n \n Materials and Methods<\/jats:title>\n \n A retrospective cohort study was conducted using electronic health records from a university setting between 2010 and 2016. Two cohorts were defined by Current Dental Terminology (CDT) codes: endodontic re\u2010treatment (\n n<\/jats:italic>\n = 1001) and single\u2010tooth implants (\n n<\/jats:italic>\n = 1822). The primary outcome was treatment failure (extraction or removal). To address the nonindependence of multiple procedures within the same patient, a shared frailty Cox proportional hazards model was employed to calculate hazard ratios (HRs) adjusted for clustering.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n The analysis included 2823 procedures. The shared frailty model revealed that single\u2010tooth implants had a significantly lower risk of failure compared to endodontic re\u2010treatment (HR = 0.21; 95% confidence interval [CI]: 0.14\u20130.33;\n p<\/jats:italic>\n < 0.001). Stratified frailty models revealed that tobacco use (HR = 2.76;\n p<\/jats:italic>\n < 0.001) and diabetes (HR = 2.37;\n p<\/jats:italic>\n = 0.007) were strong predictors of failure, specifically for endodontic re\u2010treatments, alongside thyroid problems and osteoporosis. In the implant cohort, high blood pressure emerged as a significant predictor (HR = 3.96;\n p<\/jats:italic>\n = 0.048). Unlike in standard survival models, patient age was not a significant predictor of failure (\n p<\/jats:italic>\n = 0.335) after adjusting for patient frailty.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n When rigorously accounting for intra\u2010patient correlation, single\u2010tooth implants demonstrated a superior survival advantage over endodontic re\u2010treatment in this population. However, the long\u2010term success of both modalities is significantly associated with the patient's systemic health, with specific risk factors varying by modality.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/jopr.70141","type":"journal-article","created":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T09:06:31Z","timestamp":1776157591000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Comparative survival analysis of endodontic re\u2010treatment and single\u2010tooth implants: A retrospective cohort study using shared frailty modeling"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6951-8794","authenticated-orcid":false,"given":"Georgios S.","family":"Chatzopoulos","sequence":"first","affiliation":[{"name":"Division of Periodontology School of Dentistry University of Minnesota Minneapolis Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1448-5523","authenticated-orcid":false,"given":"Larry F.","family":"Wolff","sequence":"additional","affiliation":[{"name":"Division of Periodontology School of Dentistry University of Minnesota Minneapolis Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,4,14]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"crossref","first-page":"306","DOI":"10.3390\/dj13070306","article-title":"The success of endodontic treatments performed by dental residents in advanced education in general dentistry program: a 10\u2010year retrospective study","volume":"13","author":"Al Jallad N","year":"2025","journal-title":"Dent J (Basel)"},{"key":"e_1_2_7_3_1","doi-asserted-by":"crossref","DOI":"10.1016\/j.jdent.2025.105662","article-title":"Long\u2010term survival of endodontically treated teeth: a retrospective analysis of predictive factors at a German dental school","volume":"156","author":"R\u00f6dig T","year":"2025","journal-title":"J Dent"},{"issue":"4","key":"e_1_2_7_4_1","doi-asserted-by":"crossref","first-page":"S3156","DOI":"10.4103\/jpbs.jpbs_586_24","article-title":"Single tooth implant vs non\u2010surgical root canal: long\u2010term survival rates","volume":"16","author":"Suganna M","year":"2024","journal-title":"J Pharm Bioallied Sci"},{"issue":"1","key":"e_1_2_7_5_1","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1111\/iej.13656","article-title":"A critical analysis of research methods and experimental models to study the root canal microbiome","volume":"55","author":"Siqueira JF","year":"2022","journal-title":"Int Endod J"},{"issue":"7","key":"e_1_2_7_6_1","doi-asserted-by":"crossref","first-page":"895","DOI":"10.1016\/j.joen.2011.04.002","article-title":"Impact of the quality of coronal restoration versus the quality of root canal fillings on success of root canal treatment: a systematic review and meta\u2010analysis","volume":"37","author":"Gillen BM","year":"2011","journal-title":"J Endod"},{"key":"e_1_2_7_7_1","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1016\/j.jdent.2018.02.005","article-title":"Implant and root canal treatment: survival rates and factors associated with treatment outcome","volume":"71","author":"Chatzopoulos GS","year":"2018","journal-title":"J Dent"},{"issue":"11","key":"e_1_2_7_8_1","doi-asserted-by":"crossref","first-page":"491","DOI":"10.1007\/s00784-025-06592-y","article-title":"Factors affecting long\u2010term success and survival in non\u2010surgical root canal retreatment; a retrospective cohort study","volume":"29","author":"Turan G\u00f6kduman C","year":"2025","journal-title":"Clin Oral Investig"},{"issue":"12","key":"e_1_2_7_9_1","doi-asserted-by":"crossref","first-page":"846","DOI":"10.1097\/01.don.0000145031.04236.ca","article-title":"Endodontic treatment outcomes in a large patient population in the USA: an epidemiological study","volume":"30","author":"Salehrabi R","year":"2004","journal-title":"J Endod"},{"issue":"1","key":"e_1_2_7_10_1","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1111\/j.1365-2591.2007.01323.x","article-title":"Outcome of primary root canal treatment: systematic review of the literature\u2014Part 2. 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