When a tooth has an infected root canal often times it needs to be removed and a ceramic implant placed instead. In dentistry we always try to leave the patient better off, and with old infected root canals, sometimes it is better to just remove the problem and start fresh with a zirconia implant that is not diseased and infected. With existing root canal teeth there are many factors at play here that need to be considered when deciding whether to keep a tooth and possibly retreat it or extract it and replace it with a prosthetic tooth.
Factor #1 – My research shows me that 40% of existing root canals have some sort of problem/infection with them and need to be treated
Factor #2 – Many of these teeth can be retreated with lasers and ozone and the infection eliminated, and yes, even from tubules
Factor #3 – However, often there too much infection, structural weaknesses in the tooth, or is the patient too sensitive or medically compromised to keep the tooth
I am not one to condemn all root canal teeth or one to try to maintain teeth at all costs. It depends. In my opinion and experience, one blanket philosophy, belief or approach does not fit all situations or patients.
Case Study
Here are photos from a patient in my practice who chose to remove the implant and replace it with a zirconia implant. This happens to be a situation that I did not recommend extraction but left it up to the patient. The patient decided it was best for her to remove the tooth and place an implant later.
Here is the x-ray from after the extraction showing the missing tooth. In this case I used a PRF bone/tissue graft. This is where I draw blood, centrifuge it, and place it back into the extraction site. PRF provides platelets that contain healing factors to speed up the healing process. I generally observe healing times are cut in half
This is the same tooth after healing is complete.
This is a zirconia implant from Z Systems.
This is the implant with an abutment so a crown can be placed.
This is the finished tooth. Nice!
To find more cases like this check out my Instagram page at www.instagram.com/holisticdentistry
Carey O’Rielly DDS has been a practicing dentist for 35 years. He went to USC Dental School and Duke University for his undergraduate degree. He grew up in Laguna Beach and now lives in La Costa with his wife Victoria, who runs his office.
He began his career by owning and operating a network of six offices in the San Francisco Bay Area. Presently he owns a private holistic practice in North County San Diego’s Encinitas.
Dr. O started looking for solutions to his health challenges that resulted from the stress and environmental toxicity that built up over a ten year period running his dental network. He has dedicated himself to learning about oral systemic problems and how dentistry can affect your health. He has applied what he has learned over the last twenty years to ensure he, his staff and his patients are protected from the chemicals and toxic materials found in most dental offices. He has produced an environmentally friendly office that is also peaceful and calm.
He is an expert on dental materials having looked at hundreds of biocompatibility lab tests over the years. He has identified the most bio-friendly materials to use in his practice and which dental materials can be used to replace metal fillings and crowns, including BPA free and fluoride free ‘white’ fillings. He also uses metal-free Zirconia or ceramic implants and PRF (platelet-rich fibrin) grafting materials which come from the patient’s own blood.
Dr. O’Rielly teaches C.E. courses on the systemic effects of gum disease. He is an expert in using phase contrast microscopy for analyzing dental infections, where he shows patients what kind of microbes, i.e. bacteria, amoeba, and yeasts like candida are populating the mouth and affecting the body as a whole.
He has an educational blog and is writing a book on dental health called ‘Hidden Dental Infections: Healing Root Canals and Infected Teeth with the Erbium Laser’ where he discusses dental nutrition, toxic dental materials and the effects of old root canals on inflammation and overall health.
