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Endo Tribune Asia Pacific Edition

Dr Safura Baharin Malaysia The success of any endodontic therapy depends on adequate chemical and mechanical de- bridement of the infected root canal. This requires basic knowledge of the canal ana- tomy and the ability to identify any aberration in it. Studies have shown that micro-organ- isms in the root canal system reside in the main canal, the canal’s ramification, the ac- cessory or lateral root canal, and even the dentinal tubules. Therefore, optimal debride- mentcanonlybeachievedifthe clinician is able to identify the presence of additional canals prior to or during treatment (Table 1). Currently, the only method available to assess the root, the root canal anatomy and its peri- radicular area preoperatively is through dental radiographs. Whether radiographs are per- formed intra-orally (periapical) orextra-orally(dentalpanoramic tomogram or cone beam comput- edtomography,CBCT),fractures, resorptive defects or procedural errors can also be identified this way. Thorough examination of radiographs is important, as it can provide an indication of the complexity of the treatment, in- cluding anticipated difficulties (Table 2). The use of CBCT has been widely explored and its advan- tages are well documented.1, 2 While its benefits for diagnosis in endodontic treatment cannot be Page 21 Endo Products What leading providers have to offer Page 20 Endo Congress Dr Ibrahim Abu Tahun about APEC 2015 Page 22 Endo Business An interview with MICRO-MEGA reps ENDO TRIBUNE The World’s Endodontic Newspaper · Asia Pacific Edition PUBLISHED IN HONG KONG NO. 3 VOL. 13 The significance of radiographs in endodontic therapy The 10th World Endodontic Congress IFEA Endodontic Excellence at the Apex of Africa 2016 Cape Town, South Africa International Federation of Endodontic Associations AD Factors • Angulation of the central beam Rationale • Affects the position and size of the object • Exposure time • Affects the diagnostic quality of the radiograph • Receptor sensitivity • Affects the diagnostic quality of the radiograph • Processing procedure • Affects the diagnostic quality of the radiograph • Viewing conditions • Important for identifying normal anatomical structures and presence of pathology • Clinical experience of the observer • An observer with more experience analysing radiographs may be able to detect the presence of pathology better. • Superimpositionofanatomicstructures • Affects the diagnostic quality of the radiograph • Position of the tooth in the jaw • Superimposition of anatomical structures, density of surrounding bone, single- vs. multiple-rooted teeth • Location of the lesion • Maybesuperimposedwithanatomicalstructures,such as the mental foramen, maxillary sinus or nasal sinus Table1:Factorsandrationaleswhenusinga2-Dradiographfordiagnosticpurposes.8 ! page 18ET Types Advantages Disadvantages Intra- oral Conventional periapical • Cheap • Widely used • Low radiation dose • Available in most dental clinics • Reduced chairside time ow- ing to mobile use • Sensitive technique • Superimposition of anatomical structures • 2-D image • Requires good operator skills • Requires high patient tolerance • No image modification Digital periapical • Allows image enhancement/modification (contrast, brightness, texture, size) • Low radiation dose • Immediate image display (no image processing) • Use of a mobile machine is possible; therefore, the patient does not have to move around for the radiograph • Eliminates a film processing procedure; thus, processing error can be avoided • Small image area (difficulttocapturearea of interest accurately) • Possible image enlargement • Difficultinitiallearning process concerning the manipulation of the digital software Extra- oral Dental panoramic tomogram • Complete view of the entire dentition • 2-D image • Requires larger office space for the machine • Image may not be clear enough in certain areas, particularly in the anterior CBCT • 3-D image • Image enhancement • Image can be modified • Thorough assessment of tooth • High radiation dose • Expensive • Not readily available • Requires skill to interpret the image • Requires larger office space for the machine Table 2: Types of radiographs and their advantages and disadvantages.

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