Failed root canals: the case for extraction and immediate implant placement.

t s m r a o reservation of teeth has been the treatment of hoice and a fundamental principle of dentistry. In ontrast, the extraction of natural teeth has been onsidered undesirable because of the often limited ong-term success of the alternate prosthodontic relacements. To this end, heroic efforts have been ade to preserve teeth, ranging from advanced enddontic and periodontal therapy (including hemisecions, root resections, and apicoectomies), in conunction with more conventional procedures including post and core fabrication and crown engthening). Endosseous implants, based on the bioogic and functional principles of osseointegration nd functional ankylosis, provide a predictable and ell-documented means of supporting tooth replaceents, and as such have become a routine alternative or treatment of missing teeth. When one compares he predictability of endodontically treated teeth and mplants as foundations for restorative dentistry, it is lear that the literature supports a distinct advantage f implants. The decision to extract, versus endodontically retore, a natural tooth depends on the following: qualty of support the tooth will provide for planned estorations, predicted longevity, and its role in the verall rehabilitation, functionally, esthetically, and nancially. Before any definitive treatment deciions are made, it is important to assess the quality of