Use of Cone Beam Computed Tomography in Endodontics

Figure 5

Treatment of large destructive lesions associated with pulpal pathosis benefit from 3D imaging providing better visualization of the spatial relationships of the tooth to anatomic landmarks and canal morphology. This patient presented with mild dysthesia of the right mandibular dentition. Conventional periapical imaging (a) demonstrated a large apical and mesial ill-defined rarefaction associated with the right mandibular second molar in close proximity to the inferior alveolar nerve. CBCT images ((b) sagittal, (c) cross-sectional, (d) axial) demonstrate the proximity of the lesion to the mandibular canal (MC). Therefore during treatment great care was taken to prevent obturation material extrusion past the apical terminus and possible traumatization of the IAN. Additional parasagittal CBCT images document the progression of healing at 6 months (e). In addition digital subtraction composite 3D imaging at 6 months (f) provides three-dimensional visualization of healing. (Data acquired at 0.076 mm resolution on an KODAK Dental Imaging 9000 DS (Dental Imaging/Practiceworks Atlanta, GA, USA) and 3D subtraction composite reformatted using InVivo Dental (Anatomage, San Jose, CA)).