Implant next to an RCT tooth?

Last Updated: Nov 15, 2015

I understand that if an implant is placed less than 1mm to the adjacent tooth, it will most likely lead to pulpal necrosis and root canal treatment. However, what if the tooth already has had root canal treatment – would there still be any consequences if the implant were placed closer than 1mm? What are the risk factors and their likelihood? Possible infection of the tooth or non-integration of the implant? Assuming that the coronal portion of the implant crown is far enough away from the natural tooth and has adequate angulation for restoration and only the apical area is near (less than 1mm) to the adjacent tooth with root canal treatment. Has anyone had experience with this or is there a widely accepted article with such information?

7 Comments on Implant next to an RCT tooth?

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DrT

11/17/2015

If there is a minimal volume of bone between the interproximal surface of a tooth and an implant, then just as with 2 adjacent teeth, any loss of bone will proceed very quickly. You need to follow the same guidelines for implants as you might for natural teeth...perhaps being even more strict. If the space you are dealing with means forcing the placement of an implant them you need to re-think your treatment

Emil L.A. Svoboda PhD, DD

11/17/2015

The biggest danger of placing your implant next to a tooth that has had root canal treatment (RCT) is infection that tracks from the RCT tooth. This infection can be aggressive and resistant to some common antibiotics because it has been exposed to all the antibiotics the patient has had since the RCT was completed. When the body responds to the implant surgery, it deconstructs the bone around the surgical site before it reconstructs the area with new bone. This deconstruction phase may let the dogs out of the residual peri-apical region of the RCT tooth. Beware the adjacent RCT tooth! Emil

Nitin Sharma

11/18/2015

Very well said dr. Emil

Dr. vijaykumar.b

11/18/2015

Bone thickness of 1mm or less than 1mm between implant and tooth causes decreased vascular perfusion of that area which can cause bone necrosis and loss around implant and tooth. .

David Levitt

11/27/2015

I hace placed over 7000 implants . I have never seen an endodontic issue caused by an implant being too close to the root. I have seen failing root canals infect implants even at a "safe" distance

Christine

01/28/2018

Hi, I wonder, if you can help. I have had bone/tissue graft done next to a tooth, which has a root canal and crown supported by metal post inside tooth. It appears there is an infection at the bottom of the tooth (no symptoms) and dentist (honorary consultant at a university) wants to place an implant. Says he thinks the infection is chronic and should not impact implant. This has now descended into a row and has left me shaken, confused and worried. Please advise.

Richard Hughes, DDS, FAAI

12/04/2015

I agree with Dr Levitt. The literature is far from replete on this topic. I have not seen any adverse results. There is a slim possibility of nonintegration or pulp issues. As I said its slim.

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