If the Apico fails can I still do a extract/graft/implant later?

Hi:
Most likely you can get extraction, bone graft and implant if your apico fails.  The area has to be cleaned of any remaining infection during the extraction.
Best,
Dr. Maddahi

Yes. A failed apicoectomy should not prevent you from having a successful implant supported restoration later. 

I have seen a higher success rate with apico's on anterior teeth vs back teeth and I perform some of my apico's myself.  That said, I feel the success of an apico is no better than 50/50, especially if a tooth has had a successful root canal for a number of years and then starts to have issues.I am sure you endodontist covered all the options and gave you his best estimates and has adequate experience performing.  As long as you know the COST involved and potential high failure rate and are OK with that, no reason to not try.Be aware of the money pit.....sometimes the body decides to act in a way that we cannot control and if it wants that tooth out, all the apicos in the world will not stop the process.  Make sure the first tooth is stable and asymptomatic before progressing to the next, that may at least allow a comfortable side to chew on.Good luck, eventually, odds are, you will have at least one implant, in my opinion of course!