What should be done if an endo-treated tooth has a PARL two years later?

In the context of endodontically treated teeth, the presence of a periapical radiolucency (PARL) two years post-treatment indicates that there may still be issues related to the root canal therapy. This radiolucency could signify persistent infection, inflammation, or inadequately cleaned and sealed canals that allow for bacteria to reside and proliferate.

Choosing to retreat the tooth is appropriate because it involves re-evaluating the endodontic treatment, cleaning the canals again, and possibly addressing areas that were previously overlooked or inadequately treated. Retreatment provides an opportunity to resolve these persistent issues and attempt to achieve healing of the apical tissues.

Other options, while they may seem viable in certain contexts, do not adequately address the underlying problem presented by the PARL. Observation could lead to further complications if the condition worsens and the infection spreads. Extraction, while a definitive solution, should typically be a last resort when all other treatment options have been exhausted or deemed unfeasible. Placing a temporary crown could be relevant if the tooth is stable and asymptomatic but does not resolve the underlying issue of the PARL itself.

Thus, the decision to retreat directly addresses the problem, aiming to restore the health of the tooth and surrounding