Q: What is best to save a bad tooth; pulling it and replacing it with an implant and crown, or saving the natural tooth with a root canal and crown? How do the success rates compare?
A: Great question and very timely. The Journal of Oral Implantology this month published an article on said topic.
And the answer is………………………..
But wait; lets explain what the two options are for those that have had neither.
A Root canal saves the tooth by removing the dead, gangrenous nerve tissue within the roots, which anchor the tooth into the bone like a molly bolt. Then a composite stump, called a core, is built into the tooth to make a solid foundation which will be capped with a crown. Sometimes small pins or posts are used like rebar for strength. The crown mimics the tooth you were born with.
If your doctor had deemed your tooth unsalvageable, the tooth will be removed, often followed by adding bone graft material to secure a solid base to sink a titanium implant which mimics the root of a tooth. Then a crown is connected to the implant via a post called an abutment.
Thank you for being patient; I am sure the suspense was killing you like an episode of Ozark.
And now the stats: The 10-year survival rate for a root canaled tooth, with core and crown is 73%, but an implant-supported crown is 95.2%. Advantage implant!
Although it is somewhat more costly to go the implant route it is worth it. Why? Because if you do the root canal and crown and the tooth fractures and fails, you then enter the implant route resulting in you paying twice for the same tooth. Cheap is expensive; make this decision based on your doctor’s recommendation and the current research.