Thank you so much for your reply. I have been reading and retreading your response and I have just a few followup questions. Firstly, are there any specific questions you can advise me to ask the dentist who would be doing the extraction and implant other than "am I a candidate for an implant in this area if I extract #11?"

The scan was not just a pano, it was a Galileos 3D CBCT scan. I just took a picture of my desktop when it was on the pano setting, but would there be any other view I could show you that would be helpful? I just took the pano one because I knew what I was looking at since I cant really read scans.

Finally I am wondering what to do about temporary replacement of the tooth if I do extract. Having a gap is not an option. I would be devistated. When I called today to make the consult appoint with the dentist who extracted my other RCT 7 weeks ago I asked what they do, after the extraction, if I would leave with a gap. The front desk person said they take impressions before the extraction and I can get a temporary tooth to wear until implant. My fear is because the tooth next to it, the lateral, has such short roots, can it be damaged by 6 months of wearing a temporary tooth? I imagine it would hold on to the teeth on either side, right? I've never seen one in real life, just photos. She didn't know and said I have to ask the dentist. Do you know if this is a valid concern? I don't ever want to have to lose another tooth or choose between a RCT or extraction.

Is there anything else that could be causing these symptoms that might not be related to the apico tooth? I saw an ENT who looked at the CBCT scan and said my sinuses look fine. And so it can only be tooth or nerve related he thinks. He asked me if I could live with it, if so maybe I should do nothing until I know exactly what I'm dealing with.

What would you do in my situation? Can you put yourself in my place and advise further? I'm so afraid of making a bad decision and having life long consequences.