Failed Root Canal with Chronic Abscess. Re-treatment or Abstraction and Implant? (photo)

Question

The 2009 root canal failed due to the ill-fitting crown and I now have a chronic abscess deep in the former root near my sinus. (Gum boil visible in photo). Should I attempt to save the tooth through re-treatment and a new crown or move straight on to abstraction and implant? What is the max amount of time you can go "toothless" before having an implant? Is a year too long?

J. Brian Queen, DDS · Answer

Maxillary First molars statistically have the highest failure rate after endondontics of any tooth in the mouth. If a conventional root canal fails on the Mx first molar; I counsel my patients to extract the tooth, graft bone in the socket and then proceed with implant and restoration after 3-4 months. Time is critical after the extraction as bone that is not stimulated will atrophy and possibly require additional procedures to buttress bone prior to implant placement.

Jay Neuhaus, DDS · Answer

If it were my own mouth, I would prefer the EXTRACTION, followed by an implant. Much better odds than retreating a failed Root Canal. Have an experienced Implant Surgeon do the extraction, so as to preserve and maintain healthy bone for the implant. A year is probably OK to wait AFTER the extraction. DO NOT LEAVE THE UNTREATED ABSCESS!

Gerry Curatola, DDS · Answer

Most of the latest research points to a higher predictability of success with the extraction and dental implant placement. If this tooth was part of a bridge or another circumstance, I might recommend the root canal retreatment first, as there are other logistical concerns prior to an implant placement. However based on your circumstance, the extraction and dental implant, is a better long term solution. Your dentist can review the various options for temporization to avoid being "toothless" while the implant is placed and integrating in the bone. Hope this helps.

Donald L. Wilcox, DDS · Answer

I would get the opinion of an excellent endodontist if you have not already and ask his or her opinion of the success of redoing the root canal.  A photo really does not show what is wrong with the existing root canal and how salvagable it may be.  If they can not give you a very high degree of success, I would go ahead and go the extraction and implant route.

Dan Hagi, DDS · Answer

Root canal treatment is a very successful treatment but sometimes it fails.  The subsequent re treatment has a lower success rate than the original treatment and involved time and money with a prognosis that is not best.  Also because of the chronic abscess there is likely bone damage which around a tooth can't be readily repaired.

	An implant has a high success rate and done correctly a very good prognosis.  If there is sufficient bone there is a good chance that an implant can be placed the same day the tooth is removed and a bone graft is placed around it.  This would heal for 4-6 months.  So no time going "toothless".  If an immediate implant is not possible then something temporary can be made, or just walk toothless its a back tooth :_).

	 

	Hope this helps.

Failed Root Canal with Chronic Abscess. Re-treatment or Abstraction and Implant? (photo)

Answers (7)

Answer: Implant or Have Root Canal Treatment Redone

Answer: Implant or Have Root Canal Treatment Redone

Answer: Implant vs. redoing a root canal.

Answer: Implant vs. redoing a root canal.

Recommended reading

Everything you need to know about Tooth Repair

Our mission is to create a world where every investment in modern beauty is Worth It.

Failed Root Canal with Chronic Abscess. Re-treatment or Abstraction and Implant? (photo)

Answers (7)

Answer: Implant or Have Root Canal Treatment Redone

Answer: Implant or Have Root Canal Treatment Redone

Answer: Implant vs. redoing a root canal.

Answer: Implant vs. redoing a root canal.

Browse related questions

Recommended reading

Everything you need to know about Tooth Repair

Our mission is to create a world where every investment in modern beauty is Worth It.