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Radiology · patient case question

On the same full-mouth series, which radiographic finding would most strongly indicate that a root-treated tooth requires retreatment?

Patient case: Ossifying Fibroma and Anterior Maxillary Radiolucency

demo: 31-year-old female

chief: Asymptomatic lesion noted on routine imaging.

history: Non-contributory.

meds: None

findings: A well-circumscribed lesion of mixed density is present in the posterior mandible (images below). On a separate periapical film of the maxillary central incisors, a well-defined radiolucency is seen between the roots of #8 and #9.

  1. A persistent or enlarging periapical radiolucency with poor obturation density
  2. Radiopaque sealer puffs beyond the apex with healed periapical bone
  3. A slightly short but dense obturation with no periapical change
  4. Presence of a cast post and core
Show answer and explanation

Correct answer: A. A persistent or enlarging periapical radiolucency with poor obturation density

  • A. Correct. Persistent or growing apical rarefaction combined with visible voids or an inadequate seal is the standard indication for retreatment — the disease has not resolved and the cause is identifiable.
  • B. Sealer extrusion with healed bone represents a successful biological outcome despite the imperfect radiographic appearance.
  • C. A short but well-condensed fill with healthy periapical bone is generally monitored, not retreated.
  • D. A post alone is not an indication; many well-functioning teeth carry posts.

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