Second apicoectomy will save my tooth? (Photo)

Hi Budapest!I have not seen long term prognosis of a second apico be very good.  The predictability of dental implants in 2017 should steer you this way.  Have the tooth removed and bone graft the area followed by an implant at 4-6 month! You will be happy you did this!

I believe that this fractured tooth, I do not recommend retreating you would only spend more. if you think better of another option.Good Luck :)

Based on the size of the lesion that's visible in these films, I would strongly recommend removing the infected tooth. The infection has destroyed a considerable amount of bone and appears to be impinging on the neighboring tooth. It's important to test the canine to make certain that it is still vital.I hope you found this information to be helpful,Dr. Champagne

In my experience, I have not seen very many second apicoectomies that have lasted very long.  I have removed many teeth with failed apicos.  With the high predictability of dental implants, I would personally have the tooth removed, a bone graft to fill the large defect from the failed apico, and a future dental implant. 

Hello.  Thank you for your question.  As dentists we oftentimes try really hard to save teeth.  Experience teaches us that there are times when it's better to remove the tooth. After reviewing your CT scan images, it looks like the bony defect is just too much.  The most important determinant for success is how completely the underlying infection can be removed. The best way to do that in this case is to remove the tooth.  With good ridge preservation at the time of removal you will have the option to restore with  either a bridge or an implant. Don't decide right now. If the bone height after healing is optimal then definitely go with the implant. If the resulting bone height is too high then consider a second graft or just go straight to a bridge. It is going to take a bit longer to complete treatment but the long term prognosis is going to be way better.  Hope this helps. Best of luck. 

Hi:Due to the large infection and the failure of the first apicoectomy, in my opinion it is best to extract the tooth and get either a bridge or ideally an implant.Best,Dr. Maddahi

From your enclosed CT it looks like the tooth has a vertical fracture which means it is not salvageable.  Extraction and implant would be the best choice here.

I think at this point it is best to have the tooth removed. You will need bone grafting and implant which can be done at the same time. 

I'm not sure why your first apicoectomy failed and cannot see the necessary details in the many photographs you have had. However someone has taken conebeam images and should be able to see if the root is fractured or not. As long as the root is not broken, I would try a second apicoectomy and use the most experiences surgeon that I can find. Dr. Neal