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Review
. 2025 Apr;51(1):10-16.
doi: 10.1111/aej.12917. Epub 2025 Mar 28.

Management Options and Outcomes for Root-Filled Teeth That Have a Periapical Radiolucency

Jordan Samuel Blum  1
Affiliations
Review

Management Options and Outcomes for Root-Filled Teeth That Have a Periapical Radiolucency

Jordan Samuel Blum. Aust Endod J. 2025 Apr.

Abstract

Post-treatment endodontic disease (PTED) may be defined by the presence of a periapical radiolucency in a previously root-filled tooth when the lesion can no longer be assumed to be healing. When a diagnosis of PTED is made, theoretically only three management options remain: no treatment (review and reassess), endodontic retreatment (nonsurgical or surgical), or extraction (including root resection). The purpose of this paper is to provide clinicians with a current and clinically relevant summary of the management options for PTED, with an emphasis on aetiology, case selection, and related outcomes to help clinicians filter and provide management options to the patient.

Keywords: apical periodontitis; apical surgery; endodontic retreatment; persistent disease; treatment planning.

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Conflict of interest statement

The author declares no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
Schematic diagram illustrating the various aetiologies of PTED, including (A) intraradicular infection, (B) extraradicular infection, (C) foreign body reaction depicting giant cells containing multiple scattered nuclei, and (D) radicular cyst with an epithelial‐lined cavity.
FIGURE 2
FIGURE 2
Flowchart summarising the management options for a root‐filled tooth with a periapical radiolucency.
See this image and copyright information in PMC

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