DTUK1910

July 19-25, 201018 EndoTribune United Kingdom Edition Dr Paul Jones explains how CBCT can play an important part in endodontics Fig 1: PA which tooth? Fig 2: CBCT upper second molar W hen our associate took a class on Cone Beam CT (1) , I said to myself, why would an endodontist need a CBCT? A few months later, I had what I called my “aha mo- ment”. I saw a CBCT taken by an oral surgeon on a patient I had seen twice, but had been unable to locate which upper posterior tooth was causing her pain. It was clear from the CBCT (Fig 2) that the upper second molar had a large periapical lesion that was obscured by the zygoma and the sinus on my periapical images (Fig 1). I was hooked. Now it was clear why CBCT would be use- ful in my endodontic practice. The more I use CBCT, the more valuable it has become. Here are some indications for using it in an endodontic office. Diagnosis and treatment planning Inconclusive diagnosis like my first case, most of us occa- sionally struggle with locating the tooth causing the patient’s symptoms. No tooth is any more tender to percussion, palpa- tion or mastication than any other. Nothing shows on the X-ray. The patient often can’t even tell if the problem is upper or lower. If the pathology has progressed enough to cause apical periodontitis, it should show on the CBCT. In the past, I sent that patient away and had them wait for the problem to localise. Using CBCT, I can usually find and treat the problem earlier. Low et al (2) showed that 34 per cent of lesions detected with cone beam tomography were missed with periapical radiogra- phy in maxillary premolars and molars. Suspected fractures The second most frustrating di- agnosis endodontists face is the advert kavo 3D ING 15-07-2008 9:57 Pagina 1 Colori compositi C M Y CM MY CY CMY K Affordable Cone Beam 3D.Gendex presents the GX-CB500, the latest in Cone Beam 3-D Dental Imaging. Cleverly designed for use as a powerful diagnostic and treatment-planning tool, it is perfect for implant planning and small oral surgical procedures. • Cylindrical Volume Reconstruction up to 14 cm in diameter by 8 cm in height • Scan time less than 9 sec • Full 3-D reconstruction in less than 20 seconds • Accurate volumetric rendering of critical anatomic structures • Easy to use • Compact footprint Gendex. X-Ray solutions you can trust. Gendex. Imaging Excellence. KaVo Dental Ltd. Corinium Industrial Estate Raans Road • Amersham • Buckinghamshire • HP6 6JL Tel: +44 1494 733000 • Fax: +44 1494 431168 www.kavo.co.uk www.gendex-dental.com A useful tool Fig 3: PA upper cuspid Fig 5: PA lower molar Fig 4: CBCT fractured root upper cuspid (arrow) Fig 13: CBCT shows first molar is cause of pain and swelling.