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Dental Nation
Treatment comparison

Save the tooth or extract + implant

Root canal treatment cleans and seals an infected tooth; an implant route replaces a tooth after extraction with an implant-supported crown.

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The short answer

Root canal treatment keeps the tooth by removing infected pulp, while an implant replaces a tooth after it has been extracted.

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Save the tooth or extract + implant comparison graphic

The two options, side by side

Illustrative diagram: dental implants vs root canal
Illustration — a representative diagram, not a patient photo.
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Should the tooth be kept or replaced?

Root canal treatment and an implant-supported crown compared
QuestionRoot canal routeImplant route
What happens to the toothInfected pulp is removed and the tooth is sealed.The tooth is extracted and replaced with an implant-supported single crown.[1][2]
What the review comparedRoot canal treatment and restoration.Extraction followed by an implant-supported single crown.[2]

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When does root canal treatment address the problem?

Root canal treatment removes infected pulp from inside the tooth. The tooth is then cleaned and shaped for a filling, filled, and sealed; a badly infected tooth may also need a crown.

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When is an implant replacement route being compared?

An implant-supported single crown is compared after extraction, rather than as a way to clean infection from inside the existing tooth.

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What treatment steps differ most?

Root canal treatment is usually completed over two or more appointments and may include a temporary filling. The implant route begins after extraction and places an implant-supported crown.

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What does the long-term evidence show?

In the systematic review, long-term survival for implant-supported single crowns and root canal treatment with restoration was similar. Both had higher long-term survival than fixed partial dentures.

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Long-term outcomes reported in the review
ComparisonFinding
Root canal restoration and implant single crownTheir long-term survival rates were similar.[2]
Either route and fixed partial denturesThe review reported higher long-term survival for the root canal and implant routes.[2]

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What can happen after root canal treatment?

A temporary filling may be placed between appointments. If the tooth was badly infected, it may need a crown after the root canal treatment is completed.

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What is the third choice sometimes considered?

Extraction without replacing the tooth was also included in the review. Limited data suggested poorer psychosocial outcomes than the replacement alternatives.

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What separates these two routes?

The decision separates saving and restoring the existing tooth from extracting it and placing an implant-supported crown. These are different treatment sequences, even where long-term survival was similar in the review.

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Frequently asked questions

Will I feel pain during root canal treatment?

Local anaesthetic is usually used, so you are awake but should not feel pain during treatment.

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How many root canal visits are usual?

Root canal treatment usually takes two or more appointments, which may last one to two hours or sometimes longer.

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