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X-ray of infected toothWhen 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.

Tooth ExtractionHere 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.Implant Site

This is a zirconia implant from Z Systems.

Ceramic Implant







This is the implant with an abutment so a crown can be placed.

Ceramic Implant and Abutment






This is the finished tooth. Nice!

Emax Crown


To find more cases like this check out my Instagram page at www.instagram.com/holisticdentistry