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

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.

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!

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.