I Have a Perforated Root (Crown) - What Are my Options? (photo)

Please really consider the implant. It will be the most stable option choice for decades to come with less risk to other issues vs a bridge. The perforated tooth is hopeless and needs to be replaced with an implant. in some cases (yours may be one) the implant can be placed the same day as the extraction. In certain cases immediate temporization can be completed as well to help keep soft tissue esthetics ideal. Your periodontist or oral surgeon will help you make those decisions. Do research to make sure you are seeing someone well recognized in your community. The tooth next to the perforated tooth, the other root canal tooth) does not look very good. I would also consider replacing that with an implant as well. That can be done in the near or distant future. One option, to help avoid a removable temporary, is to use a cantilever temporary form the other root canal tooth while implant or bone graft healing is being completed at the perforated tooth. I hope this helps. Good luck.

I suggest you see a very experienced Oral Surgeon or Periodontist that places lots of implants. They might want to take a different type of X-ray that will show a 3-D view of your bone, so they can tell if there will be enough solid bone to place an implant. If not, then your alternative is a bridge.

The prognosis of this tooth is poor. No matter how masterful will be an endodontist and dentist placing the crown, very limited amount of tooth structure is left, what significantly shortens the prognosis. The best viable option here will be a single implant with the crown. Usually this process is performed in stages in anterior area- extraction and grafting of the socket, than 2-3 months later -  implant placement. You should get a consult with the specialist, who is efficient in such delicate anterior cases. 

Just one look on at the x-ray tells me you have some bite issues.  Your tooth is non-restorable, and needs to be extracted. You have two options. the best option , bone graft and placment of implant, and meanwhile have a removable temporary to cover the hole for the 6-8 months that it will take to complete the process. Option two is to extract and place a bridge. Having said that please look intot he bite issue, whatever you want to do, will fail if the bie is not corrected

Good Luck