Traditionally, endodontics has relied on a 2-D image to tell us what is happening in a 3-D environment. This has produced some frustration during endodontic diagnosis and has led to some unfavorable treatment outcomes. Utilizing cone beam imaging lets us “see” what is happening in the third dimension. Using this technology we are able to find out, without reaccessing the pulp chamber, “why” cases are failing. Missed canals and perforations as well as simple failures can be seen more clearly in the “third dimension”. We can see areas of resorption that are simply not treatable, and thus save the patient time and money trying to “save” a non-restorable tooth. Utilizing the cone beam in certain cases can tell us if a tooth should even be treated endodontically or if we should move to an alternative treatment plan. The cone beam CT is another “game changer” in endodontic treatment.
Patient presented to the our office with a complaint of a swelling that “comes and goes” in the upper left quadrant. This has been going on “for years”. The referring doctor had performed root canal treatment on #11 to see if that would help. The on again-off again swelling continued so the patient was referred to us. Traditional 2-D radiographs did not show any significant pathology in the quadrant. Cone beam CT revealed an entirely missed MB root on tooth #12 with a periapical radiolucency and loss of the buccal bony plate associated with the missed root. he pulp chamber was accessed and the missed canal opened and medicated. The patient’s symptoms resolved shortly thereafter.