Should get extraction and implant or root canal with build-up, posts, and zirconium crown on tooth #19 ?

Question

I’m currently at a crossroads, I have a Large Composite Filling in Tooth #19 and it’s been there for 7 or 8 years. I will in the very near future need to make this Decision, so I wanted to hear everybody’s opinions? The tooth is basically hollowed out with the current filling, so posts and build up are necessary, plus it’s a high impact chewing force tooth, so with the lack of remaining tooth structure after a crown is placed would it inevitably fail in a few years? Should I just get Implant?

Ira Shapira, DDS · Answer

This is a legitimate question.  If the tooth is not abscessed everyone agrees it is best to restore and crown it.  Without more information there is no easy answer.  I have a tooth with a root canal in my mouth for over 40 years.  There is no good evidence that an implant will last longer than a properly restored tooth.Extracting a tooth will kill brain cells and extractions have risks as does surgical placement of implants.  These include TMJ injury, sinus openings, nerve damage etc.  Root canal treatment is 90-95% successful when the teeth are restored and can last a lifetime.  The best scenario is to restore the tooth with a crown and avoid the root canal completely.  You would have been well served with a crown when the composite was placed.

Ryan Falke, DDS · Answer

The general rule of thumb for me and my patients is if you can save the tooth and are able to get at least a few years out of it, that's the route I would suggest. If saving the tooth is not an option or it is likely to fail very soon after restoration, we talk about extraction and implant placement. Implants are the best option only if a tooth has a poor prognosis or cannot be saved. 
Best of luck with this tooth!

Nirav Patel, MDS, PhD · Answer

u will get different opinions on this. but in my practice i always go for rct first and i give implant as option once rct is no more option/possible. remember implant is last option.

Ricardo Alvarez, DDS · Answer

Hi Jim

This is a very common question and there are several facts that we need to have in mind before taking a final decision, the main fact is:

What is the prognostic after making a root canal post and crown?

If this is a good or exudes the 70% it might be a good idea to preserve it in mouth  this treatment can help you avoid the implant for another 10 years or even more the longer a natural tooth can stay in mouth the better regardless if it is with a restoration or without it. 
Best regards

DDS Ricardo Alvarez.

Amber Garcia, DDS · Answer

It's not uncommon for a previously root canaled tooth with a post to fracture and need to be extracted. If I had a molar that needed a root canal, I would probably just skip that part and have it extracted and implant placed. That being said, it's a personal decision. Some people are very adamant about maintaining their natural teeth as long as possible.

Should get extraction and implant or root canal with build-up, posts, and zirconium crown on tooth #19 ?

Answers (6)

Answer: Extraction and Implants

Answer: Extraction and Implants

Answer: Root canal vs implant

Answer: Root canal vs implant

Recommended reading

Everything you need to know about Dental Implants

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

Should get extraction and implant or root canal with build-up, posts, and zirconium crown on tooth #19 ?

Answers (6)

Answer: Extraction and Implants

Answer: Extraction and Implants

Answer: Root canal vs implant

Answer: Root canal vs implant

Browse related questions

Recommended reading

Everything you need to know about Dental Implants

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