Root Canal Question, Should I Remove And Get Implant, Or Cover It With A Crown?

I had a root canal done on my molar and a pinhole was created through the root. Should I have the tooth removed and an implant placed, or simply place a crown over the tooth. Are my chances of an infection greater now? I occasionaly have pain in the tooth.

Doctor Answers 6

Root canal treatment vs dental implant in molar tooth

The success rate of endodontic treatment in molar teeth is pretty high in cases when there is no perforation, no periapical lesions and the tooth has enough of remaining structure to place the crown. In this situation the tooth can be covered with the crown, have a long-term prognosis and remain asymptomatic. However, in many cases the symptomatic tooth after root canal treatment will have a questionable prognosis and placement of the crown will not give you 5-10 years of "using" this tooth in occlusion. 

In such situation the specialists consults are recommended, get the opinion from the endodontist and the prosthodontist, 2 major specialists who can give you an overall preview on the tooth prognosis and benefits of eather saving the tooth or replacing it with dental implant. In the cases when the tooth is broken, has absess on the apex, and questionable prognosis - it is more predictable to spend the money on the implant with single crown.

I would choose a "good" tooth over an implant

When a tooth is in good condition and its long-term prognosis is good I would always choose to keep it and place a crown when needed. I would expect that the tooth could last for many years in this situation.

 The question arises when the tooth is not in good condition.  The long-term outlook for the tooth is not as predictable.  In a situation like this I would definitely lean toward placing an implant restored with a crown.  It is a very predictable and successful option to replace a missing tooth and these days is usually a better choice than a bridge.

Speak to your dentist and a root canal specialist regarding their opinion on the long term viability of your tooth.

Martin Frankel, DDS
Toronto Dentist
3.7 out of 5 stars 3 reviews

Occasionall Pain on Root Canal Tooth

If you were told that there was a perforation made during the root canal, and you have occasional pain then generally I would recommend that you extract and place an implant.

Of course you need to weigh the cost and benefit of either decision.  How much pain do you have, and how often?  If you restore the tooth as it is with a crown and it gets worse, will you be unhappy about spending the money on the crown?

For example if you don't have much pain, just an rare occasional twinge, and don't mind having to pay for a new crown on the implant if the tooth fails - then a crown might be the easier option.  Considering that there is a fair chance the tooth with a crown will provide you with years of service.

If the occasional pain is pretty intense, and the occasions are frequent, then I would recommend just removing the tooth and placing an implant.

Hope this helps.

Best, Dr. Alper

Steve Alper, DMD
New York Dentist
5.0 out of 5 stars 3 reviews

Bad root canal, implant vs. Rootcanal, extraction or root canal

If you have a perforation and have pain upon chewing or a annoying dull or sharp pain, extract and replace with an implant. 

Mitchell A. Josephs, DDS
Palm Beach Dentist
5.0 out of 5 stars 1 review

Crown or Implant After a Root Canal?

It sounds like you had a complication with the root canal in that a perforation was made in the root of the tooth during the process of cleaning out the living part of the tooth. A root perforation can cause the root canal to fail but if the perforation is small and was managed correctly by filling the canal with a reparative filling material you can still get years of useful life from your tooth. I would wait for the tooth to become completely comfortable before investing money in a crown but once the tooth appears to be healing from the root canal and the root perforation I would go ahead and have a crown done because chances are you will get many years of useful life from the tooth.

A good rule of thumb is about a year of time will tell if a root canal is going to be successful or not. An x-ray taken every 4-6 months will also give valuable information about the status of the root perforation. 

Good luck!

Brad Lockhart, DDS
Tustin Dentist
5.0 out of 5 stars 13 reviews

Pain after root canal treatment

Root canal treatment involves removing the nerves that innervate the tooth, and thus the tooth should be symptom-free afterwards.  How long ago was the root canal done?  Sometimes the pain subsides.  However, if you continue to have pain, the root canal may need to be redone.  You may want to see an endodontist, a dentist who specializes in root canals.  Hold off on permanently cementing the crown until your symptoms have resolved.  Pain after root canal treatment can be treated and the tooth can be saved.  Best, Dr. Elizabeth Jahanian

Elizabeth Jahanian, DDS
Los Angeles Dentist

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.