What radiographic findings indicate healing at follow-up after endodontic therapy?

• A. New periapical radiolucency, persistent symptoms, and crown fracture
• B. Increased bone density around the apex with symptoms
• C. Unchanged radiograph but improved clinical symptoms
• D. Resolution or reduction of periapical radiolucency, absence of symptoms, and maintained restoration integrity

Answer: (D)

Healing after endodontic therapy is shown on radiographs by the reduction or disappearance of the periapical radiolucency, reflecting bone repair and resolution of inflammation. When this radiographic improvement occurs together with the patient having no symptoms and the restoration remaining intact, it indicates successful healing. If a new or enlarging radiolucency appears or symptoms persist, that points to ongoing disease. If the radiograph looks unchanged but the patient feels better, radiographic healing may not be confirmed yet, since bone repair is visible on imaging over time. Therefore, the best indicator of healing is the radiographic reduction or resolution of the lesion with no symptoms and an intact restoration.