In implant dentistry, we often hear the argument:
“This is not success — it is merely survival.”
And this distinction is frequently used to question implant outcomes.
Yet, when discussing periodontally compromised teeth, the same conceptual rigor is rarely applied. The tooth is often described as if it were still within the realm of success — merely needing support to “remain.”
Biologically, however, the situation is different.
A tooth that has experienced periodontitis, with measurable bone loss and clinical attachment loss (CAL), has already exited the state of structural success. Its original biological integrity has been compromised.
Maintaining such a tooth through active therapy and long-term supportive periodontal therapy (SPT) is, in practical terms, a survival strategy — not a restoration of original success.
Therefore, if we are willing to say about implants:
“This is survival, not success,”
then intellectual consistency requires us to acknowledge that a treated periodontally compromised tooth is also being maintained in a survival phase — not a success phase.
🔵 Key Insight
At this point, the distinction between “success” and “survival” becomes less a biological reality and more a rhetorical device — often unconsciously employed in favor of preserving the natural tooth rather than reflecting true biological status.