Olga,

The truth of the matter is... this tooth is chronically infected irrelevant of what procedure is done to "retain" it. Keep in mind when a dentist uses the word "save" when referring to a root canaled tooth he means "retain" as there is no "saving or curing" an infected tooth.

The fistula is blatant evidence of the spread of the infection as this means that the bacteria inside of the tooth has proliferated to the bone and tissue past the tooth. At this point your sinus could also be involved. Also keep in mind that the brain is only about 4 inches from the base of the sinuses. Infection can spread past the sinuses into the brain. So it's never a healthy idea to keep an infected tooth.

There may be too much damage and deterioration to the bone to successfully hold a bone graft and dental implant. This is one reason why it is always a huge risk to replace a root canaled tooth with a dental implant. The time factor involved in having a dental implant can be up to a year... but in the scheme of things, this is the least of your problem if you are concerned about your health which is the primary concern.

I would urge you to have this tooth removed asap and ask the oral surgeon...

1) How much healthy bone is left with regard to the placement of an implant?
2) Is the sinus involved?

Hope this info helps you...
Bryanna