When a tooth is severely decayed, infected, or damaged by trauma, the path forward involves one of two primary solutions: a procedure to save the natural tooth or a method to replace it entirely. This choice impacts your long-term health, functionality, and appearance. Understanding the distinct nature of each option is the first step toward making an informed decision with your dental professional.
Clarifying the Terminology: Endodontics vs. Implants
The phrase “endodontic implant” is a common source of confusion, as it suggests a single procedure when it represents a choice between two treatments. An obsolete procedure, the endodontic stabilizer, involved inserting a post through a tooth’s root canal into the jawbone. Due to unpredictable success, this technique is no longer used, and the decision today is between endodontic treatment and a dental implant.
Endodontic treatment, known as a root canal, is a procedure designed to save your natural tooth. It focuses on treating the inside of the tooth—the pulp chamber and root canals—by removing infected or inflamed tissue to eliminate pain and infection.
A dental implant is a prosthetic replacement for a tooth that cannot be saved. It involves the surgical placement of a titanium post into the jawbone to act as an artificial root for a new crown. An implant does not save any part of the original tooth; it replaces it completely.
The Root Canal Procedure: Saving the Natural Tooth
The objective of a root canal is to rescue a tooth that would otherwise require extraction. The procedure begins with local anesthesia to numb the area. A protective sheet called a dental dam is placed around the tooth to keep it clean and dry, after which the dentist creates a small opening in the crown to access the pulp chamber.
Using specialized instruments, the dentist or endodontist carefully removes the infected or inflamed pulp from the pulp chamber and root canals. Once the pulp is removed, the interior of the tooth is thoroughly cleaned, disinfected, and shaped to eliminate all bacteria from the canal system.
After the canals are cleaned and dried, they are filled with a biocompatible material called gutta-percha to seal the inside of the tooth. A temporary filling is placed to close the opening. Because a tooth that has had a root canal can be more prone to fracture, a permanent crown is required to protect the tooth and restore its full function.
The Dental Implant Procedure: Replacing the Tooth
The dental implant process begins with the removal of the compromised tooth. If the jawbone is not thick or strong enough to support an implant, a bone grafting procedure may be necessary first to build up the bone volume.
The core of the procedure is the surgical placement of the dental implant, a small titanium post, directly into the jawbone. Following this surgery, a healing period of several months is required. During this time, a process called osseointegration occurs, where the jawbone fuses with the implant to create a strong foundation.
Once osseointegration is complete, an abutment is attached to the implant, which is a connector piece that extends just above the gum line. After the gum tissue heals, a custom-made crown is securely attached to the abutment. This completes the restoration, providing a functional and natural-looking replacement tooth.
Key Factors in the Decision-Making Process
The choice between a root canal and a dental implant depends on several factors:
- The tooth’s condition is the primary factor. A dental professional will assess if enough healthy tooth structure remains to be successfully restored with a root canal and crown. If the tooth is non-restorable due to extensive damage, an implant is the more predictable path.
- Both procedures have high success rates. Root canal treatments have success rates between 85% and 95%, and a saved tooth can last a lifetime with proper care. Dental implants have a success rate over 95% after ten years and are known for their durability.
- A root canal is less invasive and is completed in one or two appointments. In contrast, an implant requires surgery and a much longer timeline, often spanning several months from extraction to final crown placement to allow for bone healing.
- A root canal combined with a crown has a lower upfront cost than a dental implant, which can be a more substantial initial investment, especially if bone grafting is needed. Consider the long-term value, as an implant may be more permanent, while a root-canal-treated tooth could require future retreatment.
- Keeping a natural tooth through a root canal helps maintain the jawbone via stimulation from the natural root. A dental implant also preserves bone by integrating with the jaw. An implant is a standalone unit and does not affect adjacent teeth, unlike a traditional bridge which requires altering healthy teeth.