Clinical Continued »
Endodontology position statement on the use of CBCT in Endodonticsı3 describes the following indications:
l Diagnosis of radiographic signs of periapical pathosis when there are contradictory (non-specific) signs and/or symptoms
l Confirmation of nonodontogenic causes of pathosis
l Assessment and/or management of complex dento-alveolar trauma
l Appreciation of extremely complex root canal systems prior to endodontic management e.g. Dens Invaginatus (Case ı – see p35)
l Assessment of endodontic treatment complications e.g. post perforations, for treatment planning purposes
l Assessment/management of root resorption which clinically appears to be amenable to treatment (Cases 2 and 3 – see p35)
l Pre-surgical assessment prior to complex periradicular surgery.
For information on the current
European guidelines for referring dentists and for operators of CBCT, please visit
www.sedentexct.eu
Case report A 54-year-old female patient was referred complaining of pain and tenderness from her lower left first premolar (34). Root canal treatment had been completed three weeks previously. On examination there was acute tenderness to percussion, negative sensibility testing and no buccal or lingual swelling. Radiographically there was a well obturated canal of good taper and length. There was slight asymmetry of the root filling and this can be indicative of a second canal. On close inspection of the
radiograph, a second canal could be detected. Rubber dam had been used and the canal prepared with ProTaper rotary files and irrigated with sodium hypochlorite. Obturation was with gutta percha and AH Plus (Dentsply) using a cold lateral condensation technique. Mandibular premolar teeth
Continued »
Table 1. Dose comparison – ionising radiation (approximate)6
ACTIVITY
One day background radiation, sea level
One digital PA radiograph Sirona Orthophos OPT
Sirona Orthophos XG3D CBCT 5x5.5cm FOV
Sirona Orthophos XG3D CBCT 8x8cm FOV
Chest Radiograph Mammogram
Medical CT, head
Medical Cat Scan (Spiral abdomen)
Occupation Safety Limit per year (IRR99)
EFFECTIVE DOSE (µSv)
7–8 6 14 22–40
48–91 170
400
2,000 10,000
20,000
Ireland’s Dental magazine 33
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