Etiology

-Although this approach less desirable, it is useful, short-term option if the etiology of the condition remains unknown.

- The patient must inform about what will happen if nothing is done , and his or her decision must be documented in the patient record to avoid possible subsequent accusations of abandonment .

Maybe I see lesion radiographically but the patient not complain.

- Or there is defective endodontic treatment , defective restoration

- If the patient not complain, obturation is very good , tooth is strategic and has proper restoration specially if it is bridge there is probability if I remove it it will cause cost to the patient because he will repeat it or it maybe fracture the tooth while removing restoration

- Also the success and prognosis after retreatment will be questionable

- I should be honest with the patient and inform him by all conditions and let him to decide.

- if the patient satisfaction with the tooth keep it but once the patient complain start treatment either conventional or surgical