message board How to Know When Asymptomatic Apical Lesions Need Re-Treats? A new grad asks the Townie community for help deciphering some periapical pathology. Is this a re-treat case? Chubbs Member Since: 12/16/15 Posts: 1 and 2 of 32 Endo friends, usual disclaimer: New grad trying to learn as much as I can. I saw this patient recently who has what appears to be periapical pathology at #9, #18, #25 and #30. The patient has no symptoms whatsoever and I am unable to get previous records, X-rays. He thinks #18 and #30 were done approximately 10 years ago, has no idea about #9 and #25 within the last year. How do I differentiate between active periapical pathology and residual apical scarring from a previous pathological process when the patient has no symptoms and no unusual response to percussion/palpation? Obviously, I would wait on #25 and monitor for changes, since that was done recently, but I am curious about the other three teeth. Close-ups of #18 and #30 below. The fills appear short and the teeth were never crowned so I'm not sure if or how much coronal leakage happened through the amalgam. That leaves me to believe that this is an active process. ■ 1/27/2017 mattcosta Member Since: 07/02/09 Post: 3 of 32 They all need to be retreated, with the possible exception of #9. #25 may have been recently done but it is way short and likely has a second canal that was missed. ■ 1/27/2017 42 AUGUST 2017 // dentaltownuk.comhttp://www.dentaltownuk.com