OBJECTIVES: While the success criteria of endodontic microsurgery (EMS) have been consistently defined and widely accepted, the success criteria of dental implants are outdated and focus only on the implant fixture and surrounding bone. This study aimed to evaluate the outcomes of EMS and single implants (SIs) with explicit criteria. METHODS: We searched for articles published from January 2010 to February 2022 and discussed them and consulted with a clinical advisory committee composed of four dental specialists and one epidemiologist during article selection and data extraction. RESULTS: Twenty-two EMS studies and six SI studies were included in the meta-analysis. Teeth treated using EMS had a pooled success rate of 89% (90% at <
5-year follow-up and 80% at ≥5-year follow-up) and the pooled success rate of SI was 78%. CONCLUSIONS: The success rates of the two procedures with similar follow-up periods were comparable. Subgroup analysis found no other variable that significantly influenced study heterogeneity. Considering the treatment sequence and the similar success rates, it would be advantageous to consider EMS, rather than implants, first in a situation where both procedures are applicable.