Endodontics · patient case question
Which finding indicates that this tooth requires retreatment?
Patient case: Full-mouth series in a patient with several root-treated teeth
Patient: Male, 52 years old
Chief Complaint: New patient examination. Intermittent vague discomfort in the upper right quadrant.
Background: Several root canal treatments completed at different times by different clinicians.
Current Findings: A full-mouth radiographic series has been taken. On the periapical below, one root-filled tooth shows an obturation that stops well short of the radiographic apex, with a small periapical radiolucency (arrow).
Show answer and explanation
Correct answer: C. An obturation short of the apex WITH an associated periapical radiolucency
- A. Slight extrusion of sealer or gutta-percha in an asymptomatic tooth with no periapical lesion is a technical imperfection, not a failure. Extruded material is often tolerated and resorbed.
- B. Obturation ending 0.5–2 mm short of the radiographic apex is the intended endpoint, since the apical constriction lies coronal to the radiographic apex. With no lesion, this tooth is a success.
- C. CORRECT. A short fill leaves the apical few millimetres of canal uninstrumented and unsealed. When that is accompanied by a periapical radiolucency, the two findings together mean persistent apical periodontitis from residual intracanal infection — the definition of a failing root canal treatment and the indication for retreatment.
- D. A sound restoration with no periapical change is a successful outcome. Coronal seal is in fact one of the strongest predictors of long-term endodontic success.