Why Get a Root Canal if You Can Get an Implant?

As dentist we always try to be as conservative as possible when performing treatment.  A root canal is the most conservative treatment the majority of the time.  Root canals have well over a 90 percent success rate and are many times a wise choice of treatment.  In cases where a tooth would require a post and core or the retreatment of a past root canal, it is my opinion that a dental implant would give a better long term prognosis.  There is a place and time for both of these procedures and a well trained dentist will always discuss the pros and cons with you of your particular situation. 

Saving natural teeth as long as possible is the best option and should be a priorityA dental implant could be an option when saving the natural tooth is not an option. Dental implants are great , but they can present with problems (long term/ short term) such as  peri-implantitis (infection/ gum disease) ,  bone loss, and implant fracture....

That's a loaded question! There are many factors that come into play when comparing root canal treatment and implants. Firstly, you would want to know the prognosis of the tooth. Meaning, if you are to go forward with treatment, what will be the likely outcome? In some cases, saving the tooth with root canal treatment can have a very good prognosis, and in those situations, I would opt to save the tooth with a root canal. If the tooth has already been treated with a root canal, post, and crown and is still failing for whatever reason and has a "guarded prognosis" or has a "poor prognosis" then that may be a scenario which you might want to opt for an implant. Implants have a great success rate close to 98% but can have their failures or complications as well. So you don't necessarily want to jump straight to implants if a tooth can be saved. In any case, you should go over the pros and cons for your specific situation with your dentist to make sure you understand what they recommend and why. Hope this helps!

Implants are a great alternative, however saving your natural tooth is always a better option in my opinion.  But it must be healthy and structurally sound in terms of tooth surface area and the surrounding bone which anchors it in place.  I would suggest a consultation with a good team of an Endodontist and a Periodontist along with your dentist, they will collaborate to determine what is best for you.  If a tooth has a diagnosis requiring a root canal, the nerve and blood supply are gone, however it still has a periodontal ligament which wraps around the periphery of the root and provides shock absorption.  An implant does not have this so it does not "feel like a tooth".  Keep in mind implants can potentially fail too if you don't keep up with good home care and maintenance.  Otherwise if a tooth has a poor prognosis deemed by the Periodontist, then an implant (or bridge) would be the other option.  Hope this helps.  Good luck!

The success of root canal treatment is about 90-95%, the success of dental implants is 80-95% over 10 years.  With similar success rates it really depends on the situation.  Well done endodontic treatment saves the tooth and in the future implant therapy is quite easy.  However failed implants are a complex situation that requires multiple surgeries to address.  There is nothing better than a natural tooth and our focus should be to save teeth.  Having said all that I still have patients that do not want root canals because of bad previous experiences or beliefs, we do our best to educate and replace teeth with the most biocompatible ceramic implants.

As a periodontist, I like to save teeth any chance I get. We can never replicate your tooth exactly with an implant. We can come close. But it will never be exactly the same. Although dental implants are a great treatment option and have chanted millions of people's lives forever, keeping your own teeth should be of paramount importance. If the tooth in question is not periodontally compromised, and there is enough tooth structure on top of which a crown or a cap can be cemented, then the tooth should be treated with root canal therapy. Then a crown MUST be placed on the tooth or it will fracture and then you will likely need it extracted. The more teeth you have lost, the more paramount it is to keep whatever teeth you can keep. Why? Because your teeth send signals to the brain (proprioception) telling the brain where the jaw is in space and give the relative position between upper and lower jaws in space. This is important for chewing properly and not biting your cheek and tongue constantly. So is it important to save your teeth if possible? You bet! 

Believe it or not there are more and more Endodontists ( root canal specialists) who are placing dental implants.  Why?  Because they can be very good judges of when a tooth is not worth saving and are a very trusted colleagues of the many dentists who are not comfortable with dental implants.

I am a general dentist who has been placing and restoring dental implants for nearly 30 years.  I also do many root canals on a daily basis but sometimes a judgment call based on experience needs to be made as to the long term prognosis for a tooth.  If the tooth is either too broken down, periodontally involved or the root canal faces being retreated, a dental implant may be the better choice.

Hi

If a tooth has a very good prognosis by performing a root canal and a proper restoration, then it should be the treatment of choice. If the prognosis is poor or it requires significant number of procedures to save and there are structural compromises, then extraction followed by implant should be considered as the treatment of choice. When appropriate, and performed by skillful endodontists, root canals can be very successful. It is best to do predictable dentistry, and not heroic dentistry.
 

Even though implants are an extremely successful treatment option I would recommend you try and save your tooth with a root canal assuming that the dentist thinks that the prognosis of the tooth is favorable.  Maintaining what you have is the more conservative approach.

Implants have not become substitutes for root canals.  Yes, there may be a very fine line at times between one versus the other, thus a good and professional evaluation is absolutely necessary prior to proceeding.

 

Sincerely, 

Anca Bazile, DDS, MSD Periodontist, New York City