This is a very good question than really should be answered case by case, depending on the tooth, its condition, and the availability of bone. If the tooth can be reliably treated and there is good remaining tooth structure, then a root canal and crown are a good option. If the tooth is acceptable, but not a great tooth, it would be a good idea to see a 3D X-ray to evaluate the bone to know if the tooth was removed, then there was sufficient bone for an implant. This is a situation where we are basically on the fence. If the tooth has a great deal of bone loss surrounding the tooth because of a longstanding abscess and the tooth is severely broken down, then removing the tooth and possibly doing a bone graft in the extraction site may be warranted. If the tooth has previously had a root canal and we are considering a re-treatment, then I tend to lean toward removing the tooth and placing an implant. If the tooth was severely decayed and the patient is very decay-prone, that will also push me toward removing the tooth and placing an implant. Careful evaluation is important in each case and a good, thorough conversation with the dentist is a must. I want patients to know everything about their options.
Dr. Daniel A. Lieblong