Apicoectomy vs ext-pt
 

Hello,
I have tooth #7 that was previously treated 20+ years ago due to trauma. I have crowns on 2 teeth on front and veneers on the other 2 teeth in front.I went to the dentist for a consultation about getting the crowns redone as you can see the margin line and it has pain sporadically. He referred me to an endodontics. These are his notes to the Endodontics:

Tooth #7 was previously treated 20+ years ago due to trauma. PA reveals PARL to #7 but large post is present, please eval. for apico vs ext. Pt has sensitivity to percussion and sporadic pain.

I wanted to get some feedback regarding the difference of apico vs extraction and which would be more beneficial and also more cost effective. I have no idea what price range I am looking at for either.

Thanks!

I would go for the extraction
 

I went through the same dilemma a few months back. I can only speak for my own experience, so I'm sure some are different. I did have the apico, mainly because this was a tooth more towards the front. I had continued pain after the apico and ended up having the tooth pulled about two months later. My oral surgeon said apico's have a 50/50 chance of success. That's not very good odds. Generally an apico is the final thing they can try prior to extraction. I wish I did not have the apico, and just had the tooth extracted, I would have saved a lot of pain and money. You may want to get another opinion. Also, I believe having an apico can be detrimental if you want to eventually get an implant. My personal suggestion is no, not worth it.

Apicoectomy is a barbaric procedure
 

I had an apicoectomy on a front tooth. It was an expensive 1,500. w/dental insurance, and it was so incredibly painful. It did not work and I ended up in 90+ days in pain while I went to several dentists and endodontist who continued to say "give it more time". It became nearly impossible to get it pulled because no oral surgeon would touch me without the okay from a general dentist. Finally, after the infection went to swelling my cheek and eye, an oral surgeon agreed to pull it and I spent the next 15 days on antibiotics and steroids and had signifcant bone loss due to the infection that was growing in there for 90+ days when no one would even consider removing the tooth. My layperson's advice is to get it pulled and get an implant if you are a candidate. Nothing in the mouth is forever. Even past RCTs and crowns fail or need to be replaced at some point. I wish you good luck and good health