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
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