I cannot see which 4090 you have, on my TUF 4090 the core and memory are fine, but hotspot-core ("Delta") gradually increases over time to around 20c. I recently applied fresh paste, and hotspot-core delta was <10c. Then a week later it increased to ~15c, and I guess by the end of April it'll get to that 90c zone again. It happened with two high quality pastes (Noctua NH-T2, Thermal Grizzly Kryonaut Extreme).
I'm not sure what can be done to solve it. I guess it's a mounting pressure issue, in which case changing to softer thermal pads could help, I'm also interested in testing the PTM7950. Doing monthly repasting is not a good idea, the card is way more likely to break due to the ****ty connector than due to high hotspot. I also haven't tried undervolting.