After a root canal treatment, PARL is still visible one month later. What should be the next step?

In the situation where a periapical radiolucency (PARL) is still visible one month after root canal treatment, monitoring for an additional 4-5 months is often the recommended approach. This is because it is possible that healing may still occur even if the radiolucent area is still present shortly after treatment. Bone healing can be a slow process, and it may take several months for the radiolucency to resolve completely.

During this monitoring period, the clinician can observe for any changes in symptoms or the size of the PARL. If the tooth remains asymptomatic and there are no signs of infection or other complications, it is reasonable to wait before making any intervention. This conservative management reflects a common practice in endodontics, allowing for natural healing and preventing unnecessary procedures if the tooth is responding positively.

If no improvement is seen after this monitoring period, other treatment options could then be considered based on the new assessment of the case.