Almost 15 years ago, I lost my adult #10 tooth to root absorption after
having braces for three years. They tried pretty much everything to
save it, including a root canal, but it eventually gum tissue started
to grow into a hole that had formed in the side of the root, and the
whole visible area of the tooth turned pink and then black. So it had
to be pulled. My parents and I discussed having an implant or bridge
done back then, but at the time I was a minor and they could only
afford a retainer with a fake tooth on it. I hated that thing and
eventually stopped wearing it.

Fast forward to now. I'm 30 and all the rest of my teeth are healthy,
save for a little yellowness and a tiny bit of gum recession on the
bottom incisors. I had my teeth cleaned last week, and under pressure
from my mom I asked my dentist about what they could do to fill the
hole. It also bothers me because it is visible when I talk or smile and
I don't want to keep looking like a hockey player. The dentist
recommended either a bridge or an implant.

I don't want to get a bridge, since they would have to file off or
dissolve parts of the surrounding teeth to mount it (including one or
two of my bottom teeth due to my close bite), and #9 and #11 have no
problems. Also, I've heard that teeth that have been reduced for
mounting bridges have a significant chance of needing a root canal done
on one or both at some point in the future, and after the failure of my
previous root canal I want to avoid that if possible. That leaves an
implant.

I went to see the periodontist that my dentist recommended this morning
with some X-rays that were taken the week before when I had my teeth
cleaned. He looked over the X-rays, took an impression of the upper set
of teeth, and also took lots of pictures. Apparently there's not enough
bone left to mount the post for an implant, which means I'll have to
have a bone graft done. One of the other peculiarities of my mouth is
that I have huge tori maxilaris/mandibularis on the outside that run
from the premolars to the last molars. He thinks that we might be able
to harvest some bone there and use it to build up the area over where
the implant will be. Otherwise they'll have to use bank bone, which
will be quite a lot more expensive and have less of a chance of the
graft being successful. The periodontist says he doesn't want to do a
graft from my chin because it sometimes causes people numbness in the
lower jaw, and I'd rather not have it harvested from the hip if I can
help it.

They estimated the cost at around $5,600 if they have to use the bank
bone. That covers the surgery for the bone graft with materials, and
the later surgery to mount the post after the graft has had time to
grow in. The crown is made up seperately by my normal dentist and will
cost more. That will probably mean the total cost will be around
$6,000. Is this too much?

My insurance is not paying any of this, because they won't cover
implants at all, and only cover half the cost of bridges. Even then
only when the tooth is lost during the time you have coverage. My
parents have agreed to pay for part of the proceedure.

We haven't talked over the specifics of what type of implant it will be
yet, as I'm still deciding if it is right for me. But I guess since I
don't want a bridge, there's not a lot of other options for me. I'll
see if I can get a copy of the pictures and X-rays that were taken to
post them. In the meantime, does anyone have any thoughts or advice for
me? Thanks.