Endodontics vs Implants with Omar Ikram - PDP238

Should we be doing more to save questionable teeth? Dr. Omar Ikram (  / specialistendo  ) returns for a powerful episode diving into the real-world decision-making between endodontics and implants. Together with Jaz, they explore tough scenarios — like teeth with nasty cracks or minimal remaining structure — and ask the critical question: when is it truly time to extract? They break down concepts like retained roots, root burial, amputation, and a new term Jaz introduces — palliative endodontics. Because sometimes the best outcome isn't immediate replacement, but smart, strategic delay. Protrusive Dental Pearl: When discussing treatment longevity with older patients, tailor your language to be more relatable. Instead of saying, “I plan my dentistry to age 100,” say, “I want this to last well into your eighties or nineties.” This makes the conversation more personal and realistic, helping patients better connect with the concept of long-term outcomes. Key Takeaways -Understanding the limitations of implants compared to natural teeth is vital. -Medical history significantly impacts dental treatment decisions. -Managing patient expectations is crucial for satisfaction. -Palliative endodontics can provide temporary relief and management. -Reading and interpreting CBCT scans requires skill and experience. If it's not that five -millimeter defect, it's up to you. -The second molar is a good one because often second molars can't be replaced with an implant. -Retaining roots is definitely a good way to go. -You need to risk assess the patient before extraction. -Palliative endo is technically always an option. -Success in endo can be often difficult to achieve. -Asymptomatic and functional is a good criteria. -If endo is on the table, it's feasible. Highlights of this episode: 00:00 Teaser 00:35 Introduction 01:48 Protrusive Dental Pearl 04:15 Interview with Dr. Omar Ikram: Philosophy and Growth 10:17 Endodontics vs. Implants: Treatment Planning 16:35 Antidepressants and Dental Implant Failure 19:37 Managing External Cervical Resorption (ECR) 22:30 Patient Communication 24:16 Cracks and Complications in Endodontics 29:12 Endodontic Protocol 30:50 Challenges with CBCT and Cracks 32:07 Second Molars: Retain or Extract? 35:05 Retaining Roots for Future Implants 36:21 Root Burial and Special Cases 40:08 Root Amputation: A Niche Solution 40:57 Key Signs to Rethink Root Canal Treatment 43:17 Cracked Teeth: Poor Prognosis 47:08 Stained Crack Tooth 50:19 Success vs. Survival in Endodontics 56:02 Final Thoughts and Upcoming Events Want to sharpen your endo game even further? Watch Stop Being Slow at Root Canals! Efficient RCTs with Dr Omar Ikram – PDP163    • Stop Being Slow at Root Canals! Efficient ...   Check out Specialist Endo Crows Nest (  / specialistendocrowsnest  ) — led by Dr. Omar Ikram (https://www.instagram.com/specialiste..., offering expert care, hands-on courses, and practical tips for real-world endodontics. This episode is eligible for 1 CE credit via the quiz on Protrusive Guidance. https://protrusive.co.uk/ultimate #PDPMainEpisodes #EndoRestorative #BreadandButterDentistry ----------------------------------- Apply for FREE access to the Nicest and Geekiest Dental Community in the World 🌍 https://protrusive.app - it’s absolutely Free We also have paid plans so you can Claim Verifiable CPD/CE + EXCLUSIVE content: https://protrusive.app 🔊 Subscribe on Apple: https://protrusive.co.uk/apple 🔊 Subscribe on Spotify: https://protrusive.co.uk/spotify 📷 Instagram:   / protrusivedental   Online Courses: 😬 Learn Occlusion Online: https://occlusion.online/ 📚 Learn TMD and Occlusal Appliances: https://www.splintcourse.com 🦷 Gain Confidence with Resin Bonded Bridges: https://rbbmasterclass.com 🎒 Learn Vertipreps, Rubber Dam and More: https://protrusive.co.uk/ultimate Life by KV /kvmusicprod Creative Commons — Attribution 4.0 International — CC BY 4.0 Free Download / Stream: https://www.audiolibrary.com.co/kv/life Music promoted by Audio Library Life – KV (No Copyright Music)