I fully agree with Dr. Hutter that a case report cannot replace a good scientific research study. But in the dental community it is very important that we share our experiences, if for no other reason than to stimulate interest in performing research where the literature is lacking.
As Dr. Hutter states, very few articles have been published on the communication between implants and natural teeth. There is also a surprising lack of literature on the long-term histological condition of the apex of asymptomatic endodontically treated teeth.
As for the cases presented, it is true that the limitations of the illustrations do not allow the reader to evaluate the surgeries performed. But the surgeons involved have placed an abundance of implants, and we are confident that the PDL was not involved.
Of course, there are many reasons for implant failure, but these cases stood out because they did not seem to fit any of the other common criteria for implant failure. Again, I agree with Dr. Hutter that to draw too many conclusions from case studies is inappropriate. JADA is a source of communication in our community and hopefully will inspire more work in this very important area.
