Objective: To analyse tooth loss and to evaluate the longevity of healthy teeth and teeth compromised by diseases and influenced by therapy as well as that of oral implants.
Material and methods: On the basis of an electronic and manual search using key words for survival, success, longevity of teeth, longevity of implants, epidemiology, periodontally compromised, endodontically compromised, risk for tooth extraction 49 full-text articles were identified to construct a traditional review. Among these, six systematic reviews addressing longevity were found.
Results: Tooth loss is a complex outcome, it is influenced by the extent of dental caries and its sequelae and/or the presence or absence of periodontitis as well as the decisions taken by dentists when evaluating possible risk factors for rendering successful therapy. In addition, tooth loss is related to behavioural and socio-economic factors and associated morbidity and cultural priorities. Generally, teeth surrounded by healthy periodontal tissues yield a very high longevity (up to 99.5% over 50 years). If periodontally compromised, but treated and maintained regularly, the survival of such teeth is still very high (92-93%). Likewise, endodontically compromised, but successfully treated devital teeth yield high survival and success rates. The survival of oral implants after 10 years varies between 82% and 94%.
Conclusions: Teeth will last for life, unless they are affected by oral diseases or service interventions. Many retained teeth thus may be an indicator of positive oral health behaviour throughout the life course. Tooth longevity is largely dependent on the health status of the periodontium, the pulp or periapical region and the extent of reconstructions. Multiple risks lead to a critical appraisal of the value of a tooth. Oral implants when evaluated after 10 years of service do not surpass the longevity of even compromised but successfully treated natural teeth.