Normally a two-dimensional image is taken to obtain information for diagnosis and treatment planning. These images offer only a limited view of the teeth and bony structures. The content of conventional images can be overlapped which leaves a lot of valuable information open for human interpretation.
With three-dimensional radiography, your provider obtains information of hard and soft tissues in the form of 3D voxels as opposed to pixels. Through sophisticated technology, computations are made that forms these voxels into one three-dimensional image of the area of concern. These images can be rotated and cut into slices to see virtually everything in size ratio of 1:1. This information provides a wealth of knowledge for diagnosis and treatment planning that one could not obtain otherwise. This technology leads to better treatment planning, higher success rates and an improved patient experience.
The American Association of Endodontist and The American Academy of Oral and Maxillofacial Radiology issued a joint position statement on the use of Cone Beam Computed Tomography in Endodontics. The full text of the position statement can be viewed on their website: www.aae.org and concludes with the following recommendations for limited FOV CBCT scans:
- Recommendation 1: Intraoral radiographs should be considered the imaging modality of choice in the evaluation of the endodontic patient.
- Recommendation 2: Limited FOV CBCT should be considered the imaging modality of choice for diagnosis in patients who present with contradictory or nonspecific clinical signs and symptoms associated with untreated or previously endodontically treated teeth.
- Recommendation 3: Limited FOV CBCT should be considered the imaging modality of choice for initial treatment of teeth with the potential for extra canals and suspected complex morphology, such as mandibular anterior teeth, and maxillary and mandibular premolars and molars, and dental anomalies.
- Recommendation 4: If a preoperative CBCT has not been taken, limited FOV CBCT should be considered as the imaging modality of choice for intra-appointment identification and localization of calcified canals.
- Recommendation 5: Intraoral radiographs should be considered the imaging modality of choice for immediate postoperative imaging.
- Recommendation 6: Limited FOV CBCT should be considered the imaging modality of choice if clinical examination and 2-D intraoral radiography are inconclusive in the detection of vertical root fracture.
- Recommendation 7: Limited FOV CBCT should be the imaging modality of choice when evaluating the nonhealing of previous endodontic treatment to help determine the need for further treatment, such as nonsurgical, surgical or extraction.
- Recommendation 8: Limited FOV CBCT should be the imaging modality of choice for nonsurgical retreatment to assess endodontic treatment complications, such as overextended root canal obturation material, separated endodontic instruments, and localization of perforations.
- Recommendation 9: Limited FOV CBCT should be considered as the imaging modality of choice for presurgical treatment planning to localize root apex/apices and to evaluate the proximity to adjacent anatomical structures.
- Recommendation 10: Limited FOV CBCT should be considered as the imaging modality of choice for surgical placement of implants (26).
- Recommendation 11: Limited FOV CBCT should be considered the imaging modality of choice for diagnosis and management of limited dento-alveolar trauma, root fractures, luxation, and/or displacement of teeth and localized alveolar fractures, in the absence of other maxillofacial or soft tissue injury that may require other advanced imaging modalities (27).
- Recommendation 12: Limited FOV CBCT is the imaging modality of choice in the localization and differentiation of external and internal resorptive defects and the determination of appropriate treatment and prognosis (28, 29).