Cbct technology endodontics and beyond, part 1

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Cbct technology endodontics and beyond, part 1

  1. 1. CBCT Technology: Endodontics and Beyond, Part IWritten by Jack S. Roth, DDSMonday, 07 February 2011 1854INTRODUCTIONWith this article, we begin a 2-part series highlighting the utilization of cone beam imaging into 3-dimensional (3-D) endodontics. Asan endodontist, teacher, and lecturer for more than 25 years, never has the specialty been this exciting or rewarding. Diagnosis,treatment planning, and implementation of therapy has taken on a broader perspective. With this newer abilityto image in the thirddimension, endodontists can return to the multidisciplinaryforum, offering an evidence-based approach to patient care. No longerwill anecdotal information be an acceptable methodologyin diagnosing the restorabilityon anyabutment.This evidence-based approach will be discussed and expanded upon, bridging the gap between endodontics and implantology. Inprevious generations of care, endodontics was enhanced by illumination, magnification, and, of course, nickel-titaniuminstrumentation. With the advent of cone beam computed tomography(CBCT) into the specialty, visualization and interpretation havetaken on a new dimension. Endodontics has trulyrepresented the specialtyingrained with an approach that could onlybe successfulin the third dimension. The problem, of course, was that irrigation, instrumentation, and ultimatelyobturation was judged with 2-dimensional (2-D) radiography. Even digital radiographyis 2-D. In mywayof approaching this new arena, cone beam imaging isanalogous to virtual flapless surgeryin the third dimension and can be viewed over and over again well before treatment is everrendered.IMAGING IN THE NEXT DIMENSIONLets be clear: CBCT is not a replacement for conventional radiography. Myexpectations are that traditional 2-D imaging will alwaysbe an acceptable first choice in the diagnosis and treatment of dental pathology. However, cone beam imaging is now becoming acomplementarytechnologyand in many instances a necessarypart of the diagnostic armamentarium in endodontics as well asother areas of dentistry. This technologyoffers surprisinglylow amounts of absorbed radiation2 while offering information never
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