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It sounds as though your dentist has tried all reasonable treatments to save the tooth. After two failed root canals and an apicoectomy, extraction sounds reasonable. Any other efforts to save this tooth would be heroic at best with a poor prognosis, based on past treatments. At worst, it will be a complete waste of time and money. Furthermore, any further delay in effectively treating this infection could result in serious complications to adjacent teeth and other parts of the face. Depending on your individual situation, your dentist may be able to recommend treatment to replace the lost tooth. This might include a dental implant, a fixed bridge, or removable partial. Ask your dentist to explain your options.

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Q: Is there any option besides extraction for an upper molar that has already seen two root canals an apecoectomy and now has a fistula in the gum above it?
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