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If you’re weighing the options between a root canal and a dental implant in Overland Park, Leawood, or the greater Kansas City area, you’re not alone. Many patients find themselves facing this important decision after learning about decay, damage, or infection in one or more of their teeth.
At Gordon Dental Implants & Cosmetics, we aim to help you make the best long-term decision for your oral health, comfort, and finances. Here’s what you need to know to determine which solution is right for your smile.
Save the Tooth or Replace It? Understanding Your Options
Whenever possible, saving a natural tooth is the ideal approach. A healthy, natural tooth is still your best asset — but only if it can be predictably restored for the long term. When a tooth is badly decayed, fractured, infected, or if a previous root canal has failed, replacing it with a dental implant often becomes the more viable, durable, and cost-effective option. Dr. Philip Gordon, a board-certified dental implant specialist who has placed over 10,000 implants, evaluates each case based on one key factor: “Is the tooth truly restorable for the long term?”
“Is the tooth truly restorable for the long term?”
With over 10,000 dental implants placed, Dr. Gordon carefully evaluates each case with advanced diagnostics to help you understand all available options.
A root canal is typically the preferred treatment when:
Root canals involve removing the infected nerve tissue, cleaning and disinfecting the inside of the tooth, and sealing it. However, once the blood supply is removed, the tooth becomes brittle, which increases the risk of fractures over time. This is why most root canal-treated teeth also require a crown for reinforcement, which adds both cost and complexity to the treatment.
When a root canal-treated tooth becomes problematic again, it’s often because of:
Retreating a root canal may seem like the easier option, but success rates drop significantly for second attempts. In fact, the 10-year success rate for root canal retreatments ranges between 40% and 50%, especially if there are complications like a compromised crown, failing post, or bone loss.
For many patients, the decision is not just about treating the infection, but also about ensuring that the solution lasts in the long term.
When a tooth’s prognosis is poor, replacing it with a dental implant can be a more logical and long-lasting investment. Unlike root canals, dental implants:
When factoring in the long-term costs of a failing root canal, crown, possible retreatment, and eventual extraction, a single dental implant can be more predictable, permanent, and cost-effective.
Case Study #1: Failing Root Canal with Vertical Root Fracture
The patient presented with pain and inflammation around a molar that had undergone a root canal years ago. Advanced imaging showed a vertical root fracture, making retreatment unreliable. The tooth was removed and replaced with a single dental implant, restoring complete function and aesthetics.
This patient presented with pain and chronic inflammation around a previously treated molar. The X-ray revealed a failing root canal with signs of a vertical root fracture—highlighted by the dark radiolucency and the red arrow pointing to the compromised root tip. Unfortunately, once a root canal-treated tooth develops a vertical fracture, it is no longer restorable.
After discussing treatment options and prognosis with the patient, it was determined that extracting the fractured tooth and replacing it with a dental implant would provide the most predictable and long-lasting result:
Left: X-ray showing root canal failure and vertical root fracture (arrow)
Right: Post-op X-ray showing successful implant placement and final crown
Rather than investing further into a compromised root canal-treated tooth with little chance of success, the patient opted for a permanent solution with a dental implant. The result is a healthy, functional, and aesthetic tooth replacement that will last for decades with proper care. This case clearly illustrates that when a root canal tooth fractures, replacement with a dental implant can be the most cost-effective and reliable solution, eliminating chronic pain and the risk of repeated failure.
When an older dental bridge failed due to root canal issues and bone loss under the supporting teeth, we extracted the compromised teeth. We placed two implants, which now support individual crowns with better hygiene access and long-term strength.
This patient presented with a failing dental bridge supported by a tooth that had extensive decay. One of the supporting teeth had deteriorated beyond repair, making root canal treatment and restoration nonviable. Additionally, the adjacent site had a missing tooth, compounding the challenge of function and stability.
After evaluating the restorability of the decayed tooth and discussing options with the patient, we determined that a root canal would offer limited benefit and poor long-term value. Instead, we recommended a more predictable and durable solution:
Top Left: Pre-op X-ray showing bridge with underlying decay
Top Right: Post-op X-ray with two successfully placed implants
Bottom Left: Healing abutments after implant placement
Bottom Right: Final screw-retained zirconia crowns restoring function and smile
This case highlights the limitations of attempting to salvage a severely compromised tooth with root canal therapy. Instead of investing in a procedure with low long-term success, the patient chose dental implants—resulting in a stronger, more aesthetic, and permanent solution.
The result: a healthy bite, confident smile, and a solution that won’t need to be redone in 5–10 years.
Case Study #3: Root Canal Molar Under Bridge — Replaced with 2 Dental Implants
The bridge failed because the root canal tooth beneath had recurrent decay. Instead of redoing the bridge, which would involve compromising another healthy tooth, we opted for individual implants that restored both form and function.
This patient presented with an old dental bridge supported by a root canal-treated molar that had developed recurrent decay beneath the crown. The molar was no longer restorable, and the adjacent tooth had already been missing for some time. The bridge had served its time—but now it was failing structurally and esthetically.
Given the failing root canal and the limitations of redoing bridgework on compromised teeth, we opted for a more modern and long-lasting solution: dental implants.
Top Left: Clinical photo showing the failing bridge and recurrent decay
Top Right: Final result with two implant-supported crowns replacing both the molar and premolar
Bottom Left: X-ray showing decay and failing root canal under bridge
Bottom Right: Final X-ray showing stable, integrated implants with custom abutments and crowns
This case highlights a common situation—patients often inherit bridges from years past that eventually fail due to underlying tooth decay or breakdown of old root canals. Rather than rebuild on compromised foundations, this patient chose a durable solution with individual implant-supported teeth. This approach avoids compromising neighboring teeth and restores function, esthetics, and long-term oral health.
Serving Kansas City, Overland Park, Leawood and Surrounding Areas Dr. Philip Gordon is one of the most experienced dental implant specialists in the Kansas City Metro. He and his team provide expert care for:
We use CBCT 3D imaging, guided surgery, and zirconia crowns and bridges to restore strength, function, and beauty — for life.
If the tooth can be predictably saved and restored, a root canal may be a suitable option. But if there’s structural damage, prior failure, or infection, an implant is often the better choice.
Root canals typically last 5–15 years, especially when appropriately crowned. Dental implants, however, can last 25 years or more, often for the rest of a person’s life, provided good oral hygiene is maintained.
Symptoms like persistent pain, swelling, or a pimple on the gums may indicate failure. X-rays may reveal infection or bone loss around the root.
Upfront, yes — but over time, implants can save you money by avoiding repeat treatments, crown replacements, or extractions.
Most patients report minimal discomfort with either procedure. At Gordon Dental, we offer sedation options and a comfort-first approach to ease anxiety.
Gordon Dental Implants and Cosmetics proudly provides root canal evaluations and dental implant services to patients in:
Whether you’ve been told you need a root canal retreatment or you’re exploring whether a dental implant may offer more stability, our team is here to help you make an informed, confident decision.
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