After a fistula opened on my gum at tooth 19 with a twenty year old root canal my dentist suggested a re-root canal. He did the second root canal promising that it may not be the solution as the root may be fractured though he had no way to know that for certain. The tooth never settled down and the fistula actually grew larger though it periodically fades and inflames. \n\nToday a specialist endodontist did digital images and a 3D scan to determine there is bone loss, ran a leader through the fistula to the source, and removed the resin from the second root canal to determine the floor of the tooth was not fractured.\n\nThe diagnosis is that the root is vertically fractured and requires extraction with a suggested implant. Currently the tooth is not a problem though periodically the gum is inflamed and infrequently is bite sensitive.\n\nShould I allow the extraction, and if so how soon must I act? If I get the extraction should I go for the implant or a bridge?\nI'm away from my regular dentist until October. He has referred me to a extractor in his area though I can't get there until October also. Should I get the tooth extracted and bone buildup done now, where I am? If I get it extracted locally I get to begin the healing so my regular dentist can do the crown later this year.\nThis is new territory to me as all my life my goal has been to keep my teeth in my mouth and this is the first that seemingly must go.