I'm faced with the choice of getting a tooth extracted or trying apico surgery on retreated root canal. which one should ichoose?

Apico: It is always best to have your natural teeth. The question would be how is the gum/bone support for the tooth and is it sturdy with a crown on it. If there is any question of root fracture, then an extraction might be indicated.

Tough choice..: .. And one that needs to be made by you after being given all of your treatment options. What are the conditions of the adjacent teeth? Do you plan on replacing the tooth if extracted? Considering an implant? Apicos are not guaranteed, either. So many variables to consider, that's why an internet diagnosis in this case is just not prudent.

Depends: You will get varying opinions on this for sure. If well circumcscibed/cystic lucency at apex of root, then apico more successful at solving problem. If diffuse lucency, more than one root involved, poor crown-root ratio, then better off removing tooth for a more predictable option- implant. If apico performed have bone graft to fill defect. Apicoectomies fail more often than succeed long-term.

Sorry but: There is no one pat answer or even a general agreement among dentists and dental specialists. It is on a case by case basis and if you ask 100 dentists they will probably give you an equal spread of answers. I suggest three things for you to make the decision. 1. Follow the dentist whom you trust the most 2. Then ask what he\she would do if it were their mouth? 3. Best long term prognosis?

Depends: You need to know why the root canal failed. Perhaps re-retreatment is another possible alternative to the two you listed. Has the possibility of tooth fracture being ruled out? Given your history panic attacks, i will recommend some sedative before any surgical procedures. Apico surgery is usually performed by an endodontist using operating microscope. Ask your dentist for a referral.

Risk vs Reward: A published statistical analysis of that question reveals specific pre existing conditions that influence the outcome of apicoectomies. I suggest you visit your local endodontist to review your specific case to see which of these factors are causing the conventional treatment to fail and how they will influence the outcome of the surgical process. Good luck -.