MSC - Page 23

HEALING OF PERIAPICAL PERIODONTITIS – CONE BEAM COMPUTED TOMOGRAPHY VISUALIZATION – CASE REPORT Figure 1. Preoperative radiograph of 47 Figure 2. Postoperative radiograph of 47 Figure 3. One year follow-up Figure 4. CBCT showing the periapical radiolucency in the sagittal (lower left window) and the coronal view (lower right window) The root canal treatment was performed in a single visit. Full working lengths were achieved for all three canals. After negotiating the canals with manual instruments, ProTaper Universal rotary instruments (Dentsply, Maillefer, Switzerland) was used for shaping and cleaning. Preheated 5,25% NaOCl and 17% EDTA were used as irrigants. After drying the canal, the root canal filling was performed using warm vertical condensation of gutta-percha (Fig. 2). A post was inserted and the tooth was crowned. The one year follow-up radiograph shows complete healing of the periapical lesion (Fig. 3). On the other hand, on the CBCT, especially in the coronal plan, we can visualize a clear radiolucency, CBCT-PAI 2 (Fig. 4). Conclusions CBCT is a great asset in daily endodontics, especially in the diagnosis of periapical endodontic pathosis and in the assessment of the success or failure after endodontic treatment (progression of healing of the periapical periodontitis). STOMA.EDUJ (2014) 1 (2) CBCT is a relatively new technology which should be introduced in daily dentistry. In 2010, Dr Martin Level, member of The American Board of Endodontics w as considering that 42% of the patients had to be scanned (2). The radiological beam is cone shaped and needs one single rotation for aquiring the 3D images. The visualization is axial, transaxial, coronal and sagittal. Conventional radiography is essential for an accurate endodontic diagnosis (3). However, the classical radiography is the two-dimensional expression (mesial-distal) of a three-dimensional reality, ignoring the vestibulo-lingual plane/direction (4). The information thus obtained is relative because of the incidence of the radiography. Periapical pathosis cannot be correctly viewed on a retroalveolar, isometric and orthoradial radiograph, considering the overlapping of the anatomical structures, the anatomic noise and the geometric distortion. The conventional radiograph provides us with limited information regarding the localization and the real extant 99