MANAGING ENDODONTIC PRACTICES USING CONE-BEAM COMPUTED TOMOGRAPHY: A REVIEW
Abstract
Traditionally, conventional periapical radiology formed the backbone of endodontic for diagnosis, treatment planning, and management. One of the major associated gripes being the technique created two‑dimensional images of three‑dimensional (3D) structures, suffered magnification, superimposition, and distortion, leading to compromised diagnostic information. The need to analyze the area of interesting all the possible planes led to the introduction of cone‑beam computed tomography (CBCT), a novel modality specifically designed to produce precise, undistorted 3D reconstructed images of the maxillofacial skeleton. CBCT is increasingly being embraced by various fields in dentistry, remarkably in endodontic practice. A systematic literature‑based and book‑based review was conducted using the keywords “CBCT in endodontics” and “endodontic applications of CBCT.” This article hereby discusses the prospects of CBCT in endodontics with an emphasis on its application in diagnosis and management along with treatment outcome assessment.
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References
Nair MK, Nair UP. Digital and advanced imaging in endodontics: A review.J Endod
;33:1‑6.
Langland OE, Langlais RP. Early pioneers of oral and maxillofacial radiology.Oral Surg
Oral Med Oral Pathol Oral Radiol Endod 1995;80:496‑511.
Danforth RA, Dus I, Mah J. 3‑D volume imaging for dentistry: A new dimension. J Calif
Dent Assoc 2003;31:817‑23.
Patel S, Dawood A, Ford TP, Whaites E. The potential applications of cone beam
computed tomography in the management of endodontic problems. Int Endod J
;40:818‑30.
Cotti E, Campisi G. Advanced radiographic techniques for the detection of lesions in bone.
Endod Top 2004;7:52‑72.
Durack C, Patel S, Davies J, Wilson R, Mannocci F. Diagnostic accuracy of small volume
cone beam computed tomography and intraoral periapical radiography for the detection of
simulated external inflammatory root resorption. Int Endod J 2011;44:136‑47.
Silva JA, de Alencar AH, da Rocha SS, Lopes LG, Estrela C. Three‑dimensional image
contribution for evaluation of operative procedural errors in endodontic therapy and dental
implants. Braz Dent J 2012;23:127‑34.
Velvart P, Hecker H, Tillinger G. Detection of the apical lesion and mandibular canal in
conventional radiography and computed tomography. Oral Surg Oral Med Oral Pathol Endod
;92:682‑98.
Whaites E. Periapical radiography. In: Whaites E, editor. Essentials of Dental Radiology
and Radiography. 4th ed. Philadelphia, USA: Churchill Livingston Elsevier; 2007. p. 75-100.
Wenzel A. A review of the dentists’ use of digital radiography and caries diagnosis with
digital systems. Dentomaxillofac Surg 2006;35:307‑14.
Barton DJ, Clark SJ, Eleazer PD, Scheetz JP, Farman AG. Tuned aperture computed
tomography versus parallex analogue and digital radiographic images in detecting second
mesiobuccal canals in maxillary first molars. Oral Surg Oral Med Oral Pathol Oral Radiol
Endod 2003;96:223‑8.
Lofthag‑Hansen S, Huumonen S, Gröndahl K, Gröndahl HG. Limited cone‑beam CT and
intraoral radiography for the diagnosis of periapical pathology. Oral Surg Oral Med Oral
Pathol Oral Radiol Endod 2007;103:114‑9.
Alothmani OS, Friedlander LT, Chandler NP. Radiographic assessment of endodontic
working length. Saudi Endod J 2013;3:57‑64.
Kundel HL, Revesz G. Lesion conspicuity, structured noise, and film reader error. AJR
Am J Roentgenol 1976;126:1233‑8.
Bender IB, Seltzer S. Roentgenographic and direct observation of experimental lesions in
bone. J Am Dent Assoc 1961;62:152‑60.
Schwartz SF, Foster JK. Roentgenographic interpretation of experimentally produced
bony lesions: Part 1. Oral Surg Oral Med Oral Pathol 1971;32:606‑12.
Andreasen JO. Experimental dental traumatology: Development of a model for external
root resorption. Endod Dent Traumatol 1987;3:269‑87.
Grondahl HG, Huumonen S. Radiographic manifestations of periapical inflammatory
lesions. Endod Top 2004;8:55‑67.
Friedman S. Prognosis of initial endodontic therapy. Endod Topics 2002;2:59‑98.
Farman AG, Levato CM, Scarfe WC. 3D X‑ray: An update. Inside Dent 2007;3:70‑4.
Robb RA. The dynamic spatial reconstructor: An X‑ray video‑fluoroscopic CT scanner
for dynamic volume imaging of moving organs. IEEE Trans Med Imaging 1982;1:22‑33.
Scarfe WC, Farman AG. What is cone‑beam CT and how does it work? Dent Clin North
Am 2008;52:707‑30, v.
Hashimoto K, Kawashima S, Araki M, Iwai K, Sawada K, Akiyama YComparison of
image performance between cone‑beam computed tomography for dental use and four‑row
multidetector helical CT. J Oral Sci 2006;48:27‑34.
Ramamurthy R, Scheetz JP, Clark SJ, Farman AG. Effects of imaging system and
exposure on accurate detection of the second mesio‑buccal canal in maxillary molar teeth.
Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2006;102:796‑802.
Tu MG, Tsai CC, Jou MJ, Chen WL, Chang YF, Chen SY, et al. Prevalence of
three‑rooted mandibular first molars among Taiwanese individuals. J Endod 2007;33:1163‑6.
Zheng Q, Zhang L, Zhou X, Wang Q, Wang Y, Tang L, et al. C‑shaped root canal system
in mandibular second molars in a Chinese population evaluated by cone‑beam computed
tomography. Int Endod J 2011;44:857‑62.
Estrela C, Bueno MR, Sousa‑Neto MD, Pécora JD. Method for determination of root
curvature radius using cone‑beam computed tomography images. Braz Dent J 2008;19:114‑8.
Matherne RP, Angelopoulos C, Kulild JC, Tira D. Use of cone‑beam computed
tomography to identify root canal systems in vitro. J Endod 2008;34:87‑9.
Patel S. The use of cone beam computed tomography in the conservative management of
dens invaginatus: A case report. Int Endod J 2010;43:707‑13.
Das S, Warhadpande MM, Redij SA, Sabir H, Shirude T. Management of synodontia
between dilacerated permanent maxillary central incisor and supernumerary tooth with aid of
cone‑beam computed tomography. J Conserv Dent 2015;18:163‑7.
Huumonen S, Orstavik D. Radiological aspects of apical periodontitis. Endod Top
;1:3‑25.
Estrela C, Bueno MR, Leles CR, Azevedo B, Azevedo JR. Accuracy of cone beam
computed tomography and panoramic and periapical radiography for detection of apical
periodontitis. J Endod 2008;34:273‑9.
Low KM, Dula K, Bürgin W, von Arx T. Comparison of periapical radiography and
limited cone‑beam tomography in posterior maxillary teeth referred for apical surgery. J
Endod 2008;34:557‑62.
Patel S, Dawood A, Mannocci F, Wilson R, Pitt Ford T. Detection of periapical bone
defects in human jaws using cone beam computed tomography and intraoral radiography. Int
Endod J 2009;42:507‑15.
Ahlowalia MS, Patel S, Anwar HM, Cama G, Austin RS, Wilson R, et al.
Accuracy of CBCT for volumetric measurement of simulated periapical
lesions. Int Endod J 2013;46:538‑46.
Estrela C, Bueno MR, Azevedo BC, Azevedo JR, Pécora JD. A new
periapical index based on cone beam computed tomography. J Endod
;34:1325‑31.
Patel S, Wilson R, Dawood A, Foschi F, Mannocci F. The detection of
periapical pathosis using digital periapical radiography and cone beam
computed tomography – Part 2: A 1‑year post‑treatment follow‑up. Int
Endod J 2012;45:711‑23.
Ball RL, Barbizam JV, Cohenca N. Intraoperative endodontic applications
of cone‑beam computed tomography. J Endod 2013;39:548‑57.
Cohenca N, Simon JH, Roges R, Morag Y, Malfaz JM. Clinical indications
for digital imaging in dento‑alveolar trauma. Part 1: Traumatic injuries. Dent
Traumatol 2007;23:95‑104.40. Tyndall DA, Rathore S. Cone‑beam CT diagnostic applications: Caries,
periodontal bone assessment, and endodontic applications. Dent Clin North Am
;52:825‑41, vii.
Martos J, Silva FS, Poglia ID, Damian MF, Silveira LM. Influence of X‑ray
beam angulations on the detection of horizontal root fractures. Saudi Endod
J 2015;5:129‑33.
Farmakis ET, Damaskos S, Konstandinidis C. Cone beam computed
tomography imaging as a diagnostic tool in determining root fracture in
endodontically treated teeth. Saudi Endod J 2012;2:22‑8.
Brady E, Mannocci F, Brown J, Wilson R, Patel S. A comparison of cone
beam computed tomography and periapical radiography for the detection
of vertical root fractures in nonendodontically treated teeth. Int Endod J
;47:735‑46.
Hassan B, Metska ME, Ozok AR, van der Stelt P, Wesselink PR. Detection
of vertical root fractures in endodontically treated teeth by a cone beam
computed tomography scan. J Endod 2009;35:719‑22.
Estrela C, Bueno MR, Goncalves AH, Mattar R, Neto JV, Azevedo BC,
et al. Method to evaluate inflammatory root resorption by using cone beam
computed tomography. J Endod 2009;35:1491‑7.
Maini A, Durning P, Drage N. Resorption: Within or without? The benefit of
cone‑beam computed tomography when diagnosing a case of an internal/
external resorption defect. Br Dent J 2008;204:135‑7.
Vasconcelos Kde F, Nejaim Y, Haiter Neto F, Bóscolo FN. Diagnosis of
invasive cervical resorption by using cone beam computed tomography:
Report of two cases. Braz Dent J 2012;23:602‑7.
Haghanifar S, Moudi E, Mesgarani A, Bijani A, Abbaszadeh N. A comparative
study of cone‑beam computed tomography and digital periapical radiography in
detecting mandibular molars root perforations. Imaging Sci Dent 2014;44:115‑9.
Paula‑Silva FW, Wu MK, Leonardo MR, Bezerra LA, Wesselink PR.
Accuracy of periapical radiography and cone‑beam computed tomography
scans in diagnosing apical periodontitis using histopathological findings as
a gold standard. J Endod 2009;35:1009‑12.
Rigolone M, Pasqualini D, Bianchi L, Berutti E, Bianchi SD. Vestibular
surgical access to the palatine root of the superior first molar: “Low‑dose
cone‑beam” CT analysis of the pathway and its anatomic variations. J Endod
;29:773‑5.
Bornstein MM, Scarfe WC, Vaughn VM, Jacobs R. Cone beam computed
tomography in implant dentistry: A systematic review focusing on guidelines,
indications, and radiation dose risks. Int J Oral Maxillofac Implants 2014;29
(Suppl:55-77). [doi: 10.11607/jomi.2014suppl.g1.4].
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