Endodontics

The preferred CBCT unit is one that allows acquiring a small FOV with a small voxel size; the result will be a radiographic study with high resolution that will allow evaluation of dental pathoses and relationships with adjacent anatomical structures.¹⁹ The American Academy of Oral and Maxillofacial Radiology, in conjunction with the American Association of Endodontists, published a position paper in 2015 on the use of CBCT in endodontics. The joint position paper states that intraoral radiographs should be considered the initial imaging modality of choice in the evaluation of the endodontic patient.²⁰ A CBCT should not be made in routine diagnosis or for screening purposes in the absence of endodontic signs.

Uses of a limited FOV CBCT in endodontics include evaluation of complex pulpal morphology or accessory canals, limited dento-alveolar or root fractures, or presence of resorptive defects (Figure 15). Post-treatment indications include evaluation of endodontic treatment complications, such as overextended canal obturations, separated instruments, or perforations. Pre-surgical uses include the localization of root apices and proximity to anatomical structures prior to an apical surgery.²⁰

A CBCT may be beneficial to the clinician for diagnosis in patients with contradictory or non-specific clinical signs and symptoms associated with untreated or previous endodontically treated teeth following evaluation of inconclusive intraoral radiographic findings.

Figure 15. External root resorption on distal facial aspects of root #7.

Figure 15. External root resorption on distal facial aspects of root #7.