Hi Dahlek,
I have assisted with countless extractions and also had a few of my own. So I am very familiar with the procedure and the post operative discomfort. But first, it may be helpful to understand some of the reasons why the root may have resorbed in the first place so you can take the steps to help prevent it from occuring again. It may mean having a medical physical to rule out certain systemic possibilities.

Root resorption can result from local and/or systemic issues. Some local contributory causes would be a history of orthodontics (adversely moving the teeth too quickly); internal bleaching/whitening of a root canaled tooth (because root canaled teeth naturally tend to turn gray or black); there could be a growth or cyst depriving adequate blood supply to the tooth; an injury that could have occured many years ago; or just having the tooth root canaled could cause root resorption because the procedure itself cuts off the blood supply to the tooth and also leaves the accessory canals with remnants of necrotic nerve tissue causing the roots to dissolve or resorb over time.

Some systemic contributory causes could be a hormonal or endocrine imbalance (nutritional, metabolic or immue), or disseminated malignancy (cancer that has spread from another area).

One other area that is currently being heavily researched as a possible cause of root resorption and bone deterioration is the use of Bisphosphonate drugs like Alendronate, Fosamax Etidronate, Didronel Ibandronate, Boniva Risedronate, and Actonel Risedronate. These drugs are intended to reduce the thinning of bones, however, they also decrease or eliminate the sufficiency of bone to heal. The chances of a root resorption is elevated in anyone who uses or has used any one of these drugs for any length of time because the skeletal half life (when bone turns over) is on average 10 years. So these drugs stay in the bone for at least that length of time every time they are ingested.

If none of the above seem logical in your situation, then the root resorption may be considered to be "idiopathic" or of unknown origin.

Bisphosphonates are also a concern if someone has an extraction because if the bone cannot heal, then the extraction site will not fill in and the bone can become infected.

If you have not used these medications or any other similar type medications and you don't smoke and are relatively healthy............ this type of extraction is routinely performed without complications. It is imperative that the tooth be completely removed and the socket be debrided thoroughly of all of it's contents. Yes, the infected bone would also need to be removed, but if you are adequately numb, you will not fell any of this. The post operative pain can be minimal if you prepare yourself ahead of time with proper nutrition and follow the postoperatvie instructions carefully. We find that the patients who take a homeopathic formula of Arnica for several days after the procedure do realy well with little to no post op pain and it can be taken in conjunction with pain meds.

As for replacement of that tooth......... that all depends on how infected the bone is; how much bone will be removed; your overall health and if you have taken Bisphosphonates.

I know this is very scary........ but try to look at this as getting rid of something negative in your body that can be causing your immune system to work too hard.

Please let us know if you have any other questions or concerns. Also, let us know how you're doing!

Bryanna