Tooth Implant on Bone Graft?

[tehtoothlessone]

I recently went to a dentist because of a filling fell out on tooth 19.   It appears that decay continued or another cavity started, and the decay continued down the side my tooth to the bone.  Oddly enough, I really had no pain to signify a tooth problem until a portion of the crown / filling collapsed and currently the only pain I get is from water.  The dentist stated that because the cavity was to the bone, there was no easy way to put a cap on it because of lack of support.   The dentist gave me two suggestions: an implant+crown or a bone graft and a root canal and finish that off with a crown.  However, he highly suggested not to get the bone graft as it'll make the next tooth (18) unstable, and the tooth may fail again in soon future.

Cost is not really an issue, but I'm curious on the better approach from others.  I understand that titanium posts are subjected to rejection, but what's the probability of this?  Given a capable doctor, what's the probability of instability causing problems with my bone graft/root canal method?

[tehtoothlessone]

Scott,

I believe the concern is that the cavity has almost reached the pulp.  From what I read, the implant route has a high success rate (around 95%), but I haven't found anything on the osteoplasty and complications in regards to neighboring teeth.  

Thanks for your reply.

[scottma]

Your descriptions suggest crown lengthening or osteoplasty procedure is indicated. the purpose of surgical procedure is to establish optimal biologic width. Root canal has nothing to do with the procedure, unless dental pulp is encroached by cavity. Seeing a periodontist to have a detailed consultation is advised.