A properly cleaned root canal system removes the vast majority of the dead tissue and infection within the canal system. That is the goal. Some authorities rightly worry about residual tissue, bacteria, and the corresponding pathologic byproducts that are left following root canal therapy. This is why Dr. Nick has added the combination of erbium laser PIPs (to create a cavitation effect with expansion and successive implosion of fluid chemistry used to clean the root canals) with ozonated water (to neutralize bacteria via destroying the bacterial cell walls) to improve the other steps of a well-performed root canal therapy.
Exactly how much of what’s left can promote chronic problems systemically, and is this tolerance the same for all patients? At what point does one sacrifice the tooth and proceed to implant therapy? What other factors need to be considered? There is often a lot to consider. Firstly, if a tooth, its roots and the ligaments connecting root to bone are removed, there no longer remains a neurological connection to the Central Nervous System (think brain) which coordinates chewing/muscular function (the main purpose for our teeth). If you remove the tooth, you lose the connection. Additionally, if you remove the tooth, the bone will melt away, often disallowing the chance of future implant placement for full subsequent restoration. Only roots and implants stimulate bone to remain. This is very important because there are times that the positives (keeping neurological connection and keeping bone around) out way the negatives (dealing with a not quite sterile and clean root canal system).
Every case is different. In Dr. Nick’s practice, if an effective root canal can be accomplished all the way to the root tips, his experience and confidence with the combination of laser and ozone usage coupled w/ state-of-the-art nickel titanium mechanical cleaning and shaping (with the associated chemistry to aid in cleaning) leans him towards retaining that “ neurological connection”, IF the tooth sits in a crucial place within the dental arch. In cases where the anatomy is too complex for an effective root canal or the tooth is not as important to retain, he recommends removal. Implants are great, but often times it’s better to have a well done root canal therapy than it is to remove it.
Conversely, there are times to remove rather to perform root canal therapy. Every single case is different. At the end of the day, the decision to retain or remove relies on the patient after proper and thorough informed consent is delivered from Dr. Nick.