Does this fractured tooth need to be extracted or can it be saved? (Photo)

 Judging by the x-ray that you posted, it appears as though the root of the tooth is fractured in such a way that It is not savable.Since the adjacent teeth appear to be in very good condition,  it would not typically be recommended to file them down and do a bridge. Assuming that you want a final result that does not come out at night, then the only two options left would be either a dental implant or a more conservative bonded bridge such as a Maryland bridge.  If you choose to go with the dental implant, then a flipper is no longer the recommended temporary tooth replacement during the healing process. You would either want to consider a removable appliance called an Essex appliance, or a bonded temporary that is connected (temporarily) to the two adjacent teeth during the healing process.I hope you found this information to be helpful,Dr. Champagne 

Unfortunately, i must tell you that the x-ray you posted shows an oblique fracture completely through the root of this tooth and this is an non-savable tooth.  It must be extracted immediately to avoid an infection. There are different options to restore the missing tooth.  1. A "flipper" interim partial denture like a retainer with a tooth attached to it can be used and is the least expensive option.  This can also be used to make a socially presentable smile while allowing the socket to heal for a future implant or bridge,2. A Fixed-Maryland or Conventional Bridge can be fabricated once the soft tissue of the socket is healed after a few weeks.3. An implant can be placed and an abutment and crown can be fabricated to fit onto the implant. This is the best but most expensive option.Good luck and you will be smiling again soon.

Your best option is an implant hopefully placed at the time of extraction with a temporary crown placed as well. This will eliminate your need for a flipper and will maintain your gum tissue during the healing phase. This is commonly called an immediate implant. Sometimes, the implant cannot be placed immediately and will require a flipper or an essix appliance. I prefer an essix appliance. This stays off your palate and off your gum tissue at the surgical site.Another option is to place a 3 unit cemented bridge. Unfortunately it would require reducing your adjoining teeth and place crowns on those teeth. If you were my patient I would recommend the immediate implant.  Good luck to you!

Once you have a fracture underneath the bone, you will get an infection and lose more bone. This happens slowly and sometimes quickly. This fracture may have affected the bone on the outside so some bone grafting may be needed to prevent gums from growing in through the crack. An implant will be your best option. You have natural teeth, so a glued temporary to the neighbor is also possible.

The root filled incisor seems to have a deep fracture under the gum. This could lead to infection and bone loss if not treated. If it is not mobile, there is a danger that on biting you could fracture the tooth further. My advice would be remove the tooth and place an immediate implant. You may be able to place an immediate temporary crown, but I would try avoid loading the implant band wear a small denture or aligner with a plastic pontic tooth, or even a stick on temp. bridge.