https://www.westonaprice.org/health-topics/dentistry/dental-cavitation-surgery/

“A periapical view, which is a specific x-ray of the root of the tooth in question, is essential to diagnosis. If there is a clear radiolucency at the root of the tooth; that is, a black circular area, this is an indication of a cavitation or hole in the jawbone. This area of chronic ischemia (lack of blood supply) and infection is referred to by various terms (osteonecrosis, osteomyelitis, NICO, etc.), but broadly speaking it is a dental focal infection. When there is an obvious radiolucency apparent on x-ray there is very little one can do to save the tooth, although some dentists have been able to reduce and even clear very small cavitation areas through ozone injections. However, in most cases, when the x-ray is positive, the decision whether to do a root canal or extract the tooth then needs to be made.”

“In contrast, if a patient has suffered from chronically ill health for many years, then the decision of whether to extract a devitalized or root canal tooth is clearer. In these cases surgery is typically very appropriate. Or, for example, if a patient receives a grave diagnosis such as breast cancer, it is important that all root canal teeth anywhere in the mouth—but especially ipsilateral to the breast—be cleared in the face of this serious disease in order to try to save the patient.”