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The use of cone beam computed tomography in endodontic re-treatment

From Volume 50, Issue 6, June 2023 | Pages 531-534

Authors

Daniel Caga

BSc (Hons), BDS (Hons/Clinical Dist), Dip Rest Dent RCS (Eng), MSc (Dist), MCGDent, BSc (Hons), BDS (Hons/Clinical Dist), Dip Rest Dent RCS (Eng), PG Cert

Associate Dentist, 606 Dental Practice, Solihull

Articles by Daniel Caga

Email Daniel Caga

Abstract

Radiography plays an integral role in endodontics. However, conventional radiographic techniques have limitations, such as background noise, providing only a two-dimensional representation of the image, superimposition and distortion. Cone beam computed tomography (CBCT) provides the clinician with a three-dimensional image of the structures involved in the clinical situation. When considering options for endodontic re-treatments, it is vital to identify the cause of the initial failure and here, the use of CBCT images can be beneficial. This is illustrated through an endodontic re-treatment case owing to a palatal canal missed with conventional radiographic techniques.

CPD/Clinical Relevance: Cone beam computed tomography can be beneficial in cases of endodontic re-treatment.

Article

When faced with a recurrent apical infection following primary endodontic treatment, the clinician must first identify the cause of the failure before embarking on re-treatment. Endodontic re-treatment can include non-surgical and surgical procedures. Radiography plays an integral role in endodontics; however, conventional radiographic techniques have limitations, such as background noise, providing only a two-dimensional (2D) representation of the image, superimposition and distortion.1,2

Following appropriate training in the use and reporting of cone beam computed tomography (CBCT),3 endodontic specialists, dentists with a special interest in endodontics, as well as general dental practitioners (GDPs) can now readily acquire three-dimensional (3D) images of the structures involved in the clinical situation in the form of CBCT scans. CBCT imaging can help overcome the various limitations affecting traditional peri-apical radiographs.1 However, the application of CBCT imaging should be considered on a case-by-case basis as CBCT does involve greater radiation exposure4. Factors influencing exposure dose include the CBCT unit being used, as well as the case requirements (ie size of the area being assessed).1

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