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Did Your Root Canal Fail? Should You Have An Apicoectomy Or Get A Dental Implant Instead?

30 October 2015

Oscar Allen

A root canal can immediately end the pain of a tooth that's infected at its core, allowing the majority of the natural tooth to remain under a dental crown. That's considered healthier for the patient (you) because missing teeth can cause a host of problems, including shrinkage of the bone in your jaw, a problem with your bite, shifting teeth, and a gap in your smile. However, about 5% of root canals eventually fail and the pain comes back. At that point, you have a choice between an apicoectomy and a dental implant. This is what you should know.

How is an apicoectomy used when a root canal fails? An apicoectomy, or root-end resection, is a surgical procedure designed to stop a tooth that's already had a root canal from getting reinfected. It's a short procedure, taking only about 30 minutes. The oral surgeon will bore a hole into the bone at the very tip of the problem tooth's root. The tip is then cut off and the sealant is used to fill the hole.

The procedure is often covered by insurance and ends up costing the patient $100–$500 out of pocket. Without insurance, the cost can be $1,300 or more. However, you may just be prolonging the inevitable loss of the tooth anyhow, because around 40% of people who have an apicoectomy lose the tooth within 5 years. 

How is a dental implant used when a root canal fails? A dental implant is used when you or your dentist decides that it is time to give up on the idea of saving the natural tooth and extract the tooth entirely. An artificial tooth is then surgically placed in the space left by the extracted tooth. Most of the time it is held in place with screws, cylinders, or blades that are placed in the jawbone. The jawbone eventually grows around the tooth, making it a permanent solution.

The full process usually takes several procedures and costs a lot more than the apicoectomy. A single tooth implant costs an average of $4,250. Most dental plans don't cover implants. Dental implants are more successful than apicoectomy procedures, however, with 95% or more people still having success with their implants 10 years later.

How do you know which procedure to choose?

An apicoectomy isn't a bad idea if you want to save the natural tooth and want a procedure that offers a quick solution to your problem. If the natural tooth is structurally sound and there's no obvious reason that it keeps getting reinfected, an apicoectomy is certainly less financially prohibitive. If the tooth is structurally weak and shows signs of being fractured or decayed, however, an apicoectomy could end up being a waste of time and money.

Sometimes people want to try an apicoectomy even though they know that their problem tooth has spots of decay or cracks in it. Usually, they're hoping to avoid the expense and time involved with an implant. The problem with that approach is that the hole that's drilled in the jawbone for the apicoectomy is right where the implant needs to be secured. That can make it harder for the implant to bond with the bone if the apicoectomy fails and you have to fall back on the dental implant.

For more information, contact a local dentist like Colerain Denture Center to discuss your options.

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