Are implants are the new replacements for root canals?


I remember when it was standard operating procedure to try and save every tooth possible. If a tooth had a nerve was exposed or a tooth had an endodontic periapical lesion then a root canal, post and crown was the treatment of choice even,  if crown lengthening might be needed. Not so much now a days. Many teeth that we would save in the past are now deemed questionable and too risky to save. Often extraction and implant restorations are the treatment plan chosen. I, given the money involved most dentists and our patients  opt for the most predictable treatment plan that will result in a long lasting result.

Implants,  in the proper situation, are very predictable and end up costing about the same as restoring a tooth that requires  root canal, post and core, crown lengthening and then a crown. Further more teeth with root canals seem to be more prone to fracture than regular teeth and implants as well. That being said, there are still plenty of reasons to "save this old tooth''.

If the tooth has enough bone support and enough remaining ferrule ( viable exposed tooth structure to hold a crown), than root canals and a crown restoration afterwards isthe still the preferred treatment plan. Root canals have over a 95% success rate. When  properly restored with a crown,  teeth often can remain in the mouth for 10+ years. Some of my patients have teeth that had root canal performed 40 years ago and are still functioning well.

Since even implants may not last indefinitely, having a root canal and a post and a crown that may last 15 to 20 years is a good way of "kicking the can down the road". Most likely if the  tooth does fail and need to be extracted, by that time our profession will have improved our implant techniques and the implant should end up being even a better replacement (than one done using today's protocols).

Now many endodontists take care to conserve tooth structure when performing their root canals since the profession is in general agreement that conservative root canal preparation that conserves tooth structure makes subsequent root fractures less likely. That coupled with tooth conservative crown preparations make long lasting results even more likely.






from Ask Dr. Spindel - http://lspindelnycdds.blogspot.com/2019/05/implants-are-new-replacements-for-root.html - http://lspindelnycdds.blogspot.com/

Comments

Post a Comment

Popular posts from this blog

Help! My Child is Terrified of the Dentist

Image
If you’re the parent of a young child, you know their brains are similar to sponges that soak up everything around them—especially in their first five years, which neuroscientists say is when they’ll do the most learning and developing in their entire life. At this formative time, your child may amaze you with what they notice: your facial expressions, the different tones of your voice, and your habits. If your habits include regular dental visits and an excellent oral hygiene routine, they’ll notice and want to emulate you. If you happen to feel anxious about your dental visits, or you groan when you’ve got to floss and brush, they may synchronize and feel your dread. This could lead to dental fears that stick with them for years—potentially a lifetime! Kids Can Be Courageous If you’re feeling guilty right now, go ahead and put that away as it won’t serve you or your little one. Everyone has some room for improvement, and Coastal Pediatric Dentistry® is here to help show you an...
Read more

Going for the Gold?

Image
On the left is the older allow, on the right the new one that my lab has chosen to use The cost of a penny weight of pure gold is currently $79.53. The cost of a penny weight of pure palladium is $130.6. It used to be that palladium was added instead of gold to the precious metals often used for pfms, but now laboratories are finding that palladium is no longer affordable. The lab that I am using has just changed the formulation of the metal it's using to one that has more gold than palladium. I really do not mind, but metals with more gold are softer and often easier for a dentist to accidentally polish off delicate margins. It is important when polishing "higher gold" formulations to exert less hand pressure when performing the final polishing of the crown's margins. Other wise there should be no problem with this change. Traditionally labs have chosen alloys with higher gold percentages for optimal esthetics, since alloys with higher concentrations of ...
Read more

Lemon Juice – The Good, the Bad, & the Sour

Image
In a great tale of opposites, lemon juice can be both acidic and basic, or alkaline. Read on to find out why people are talking about this, and what it means for your oral and overall health . What is pH and why does it matter? Drinking lemon juice (usually diluted in a glass of water or added to a cup of tea) is a beloved health tonic among fans of natural medicine. Potential benefits include lower cholesterol, lower inflammation in the body, and increased metabolism and energy. Lemon also contains high levels of antioxidants and vitamin C that boost your immune system. On a scale from 0-14, a pH of 7 is neutral (pure water) while numbers below 7 are acidic (unhealthy), and above 7 are basic or alkaline (healthy). Believers in holistic health blame many ailments on the body’s pH being too low or too acidic. Increasing your body’s pH is called “alkalizing.” Lemon juice in its natural state is acidic with a pH of about 2, but once metabolized it actually becomes alkaline with a pH ...
Read more