I have several teeth that have previously undergone root canal treatment, and some of them also have posts. I have been told that there are infections around a few teeth and that my case may be more complex than a routine smile makeover.
Which teeth may need to be extracted, how many implants might I need, and can I still have a full zirconia smile restoration?
Answers (1)
From our board-certified dentists and trusted medical professionals
Eda T.
Dentist
Answered on Aug 13, 2026
ANSWER
Your case is relatively complex because several of your existing teeth have previous root canal treatments and posts, and some areas show signs of infection. For this reason, the treatment plan may need to be adjusted after a detailed clinical examination and three-dimensional CBCT evaluation.
Tooth 16 has previously received root canal treatment, but a separated instrument is present within the canal. If there is an infection around the root tip or the tooth is painful when biting or during percussion testing, extraction may be necessary, followed by implant placement.
Tooth 26 has an infection that may not be predictable to treat successfully with another root canal procedure. Therefore, extraction and implant placement are likely to be recommended.
Tooth 37 has a large infection around the root tip and is likely to require extraction.
The remaining root canal-treated teeth may be preserved if they are clinically stable and free from significant infection. Additional fillings or restorative treatment may be added to the final plan depending on the condition of these teeth.
The provisional treatment plan includes:
Possible extraction and implant placement for tooth 16, depending on symptoms and infection
Extraction of tooth 26 and replacement with a dental implant
Extraction of tooth 37
Five dental implants planned for the regions of teeth 16, 26, 36, 44, and 45
24 zirconia restorations for teeth 16–26 and 31–36, 41–46
Professional dental cleaning
A custom night guard to help protect the final zirconia restorations
Additional fillings if required after clinical assessment
The number of extractions and implants may increase if further teeth are found to have a poor prognosis during the examination.
For the tooth 26 region, immediate implant placement may be possible if the infection can be adequately controlled and the remaining bone provides sufficient stability. If immediate placement is not suitable, the implant may need to be postponed until a second visit after the area has healed.
Because several teeth have previous root canal treatments and infections, this should be considered a provisional treatment plan. The final number of implants, extractions, fillings, and restorations will be confirmed after clinical examination, CBCT imaging, and evaluation of the condition of each individual tooth.