DENTASCANS IN ENDODONTICS      INDIAN DENTAL ACADEMY   Leader in Continuing Dental Education     www.indiandentalacademy.com
Contents•   Introduction•   Case Report.•   Discussion.•   Conclusion.•   References.          www.indiandentalacademy.com
PROPER TREATMENTACCESS CAVITY       OBTURATION           RESULT                www.indiandentalacademy.com
FAILUREANATOMICVARIATIONS              FAILURE      www.indiandentalacademy.com
CONVENTIONAL IMAGING    TECHNIQUES PERIAPICAL RADIOGRAPHS PANORAMIC RADIOGRAPHS                     1: EASY               ...
DENTASCANS• Dentascan, was developed by Schwarz  et al. in 1987                                       www.indiandentalacad...
DENTASCANS PRIMARYINDICATIONS Pre-evaluation of implant sites Buccolingual extent of cysts and tumours  Inflammatory lesio...
CASE              REPORT• 45 yr male patient• Chief complaint : Swelling in right side  of face.• Medical history was not ...
IOPAwww.indiandentalacademy.com
Extra canals in right maxillary molars        Extra canals in maxillary left first and second molars                      ...
Axial image showing extra canals in           multiple teeth                            www.indiandentalacademy.com
: Axial image showing loss of cortical plate in         distobuccal and palatal root of          3D image showing loss of ...
Paraxial image of maxillary first molar           showing MB root       with periapical infection  with maxillary sinus in...
3D volume rendering showing loss of      3D volume rendering showing furcation    buccal cortical plate in right          ...
Mandibular anterior region showing periapical infection with loss of labial cortical plates            www.indiandentalaca...
www.indiandentalacademy.com
LIMITATIONS OF TWODIMENSIONAL IMAGING•Extra canals are a common findings andmissing of these canals leads to endodontictre...
Root canals tend to lie one behind theother in buccolingual plane, they getsuperimposed onto each other onperiapical & pan...
Dental CT : An    alternative•Dental CT is reformatting softwareused along with spiral /helical CT andallows assessment in...
Orientation of the scan                      Maxilla:                      Parallel to the                      hard palat...
Marking of points             along the ridgewww.indiandentalacademy.com
Paraxial images   markings   www.indiandentalacademy.com
Panoramic images    markings    www.indiandentalacademy.com
3D volume rendering showing loss of      3D volume rendering showing furcation    buccal cortical plate in right          ...
Present case• . •Access cavity revealed five canals. •Dental CT determined the extend of periapical infection associated w...
MAXILLARY SINUS HYPERPLASIA• Hyperplasia of maxillary sinus mucosa  was seen, suggesting that periapical  infection could ...
MULTIPLE EXTRA CANALS• Extra canals were also found in other  teeth with periapical infections in lower  anterior teeth.  ...
Limitations of Dentascans    Cost factor                   Radiation dose           www.indiandentalacademy.com
CONCLUSION•Radiographic examination is an essential part ofdiagnosis in endodontic. Two dimensional imagingcannot depict v...
REFERENCES•   1: Soraya Robinson, C. Czerny, A. Gahleitner, T. Bernhart and F. M. Kainberger,Dental CT    evaluation of ma...
REFERENCES• 12: Sierashi SM. Identification and endodontic management of  three-canaled maxillary premolars. JOE 1989; 15:...
Thank you  www.indiandentalacademy.com
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Denta scans in endodontics /certified fixed orthodontic courses by Indian dental academy

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Denta scans in endodontics /certified fixed orthodontic courses by Indian dental academy

  1. 1. DENTASCANS IN ENDODONTICS INDIAN DENTAL ACADEMY Leader in Continuing Dental Education www.indiandentalacademy.com
  2. 2. Contents• Introduction• Case Report.• Discussion.• Conclusion.• References. www.indiandentalacademy.com
  3. 3. PROPER TREATMENTACCESS CAVITY OBTURATION RESULT www.indiandentalacademy.com
  4. 4. FAILUREANATOMICVARIATIONS FAILURE www.indiandentalacademy.com
  5. 5. CONVENTIONAL IMAGING TECHNIQUES PERIAPICAL RADIOGRAPHS PANORAMIC RADIOGRAPHS 1: EASY 2:ECONOMICAL LACK OF PERCEPTION IN THIRD DIMENSION www.indiandentalacademy.com
  6. 6. DENTASCANS• Dentascan, was developed by Schwarz et al. in 1987 www.indiandentalacademy.com Schwarz MS, Rothman SL, Rhodes ML, Chafetz N . Computed tomography.I. Preoperative assessment of the mandible for endosseous implant surgery. Int J Oral Maxillofac Implants 1987 2:137–141
  7. 7. DENTASCANS PRIMARYINDICATIONS Pre-evaluation of implant sites Buccolingual extent of cysts and tumours Inflammatory lesions of the jaws www.indiandentalacademy.com
  8. 8. CASE REPORT• 45 yr male patient• Chief complaint : Swelling in right side of face.• Medical history was not significant.• Badly carious maxillary right first molar with obliteration of buccal vestibule www.indiandentalacademy.com
  9. 9. IOPAwww.indiandentalacademy.com
  10. 10. Extra canals in right maxillary molars Extra canals in maxillary left first and second molars www.indiandentalacademy.com
  11. 11. Axial image showing extra canals in multiple teeth www.indiandentalacademy.com
  12. 12. : Axial image showing loss of cortical plate in distobuccal and palatal root of 3D image showing loss of palatal and right maxillary first molar buccal cortical plate www.indiandentalacademy.com
  13. 13. Paraxial image of maxillary first molar showing MB root with periapical infection with maxillary sinus inflammation www.indiandentalacademy.com
  14. 14. 3D volume rendering showing loss of 3D volume rendering showing furcation buccal cortical plate in right involvement with left mandibular second molar maxillary first molar region www.indiandentalacademy.com
  15. 15. Mandibular anterior region showing periapical infection with loss of labial cortical plates www.indiandentalacademy.com
  16. 16. www.indiandentalacademy.com
  17. 17. LIMITATIONS OF TWODIMENSIONAL IMAGING•Extra canals are a common findings andmissing of these canals leads to endodontictreatment failure.•Intra oral radiographs - anatomy in thethird dimension cannot be assessed www.indiandentalacademy.com
  18. 18. Root canals tend to lie one behind theother in buccolingual plane, they getsuperimposed onto each other onperiapical & panoramic radiographsand easily go undetected Soraya Robinson, C. Czerny, A. Gahleitner, T. Bernhart and F. M. Kainberger www.indiandentalacademy.com ,Dental CT evaluation of mandibular first premolar root configurations and canal variations . Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2002;93:328-32
  19. 19. Dental CT : An alternative•Dental CT is reformatting softwareused along with spiral /helical CT andallows assessment in all threedimensions.•It provides axial, panoramic,paraxial and 3D volume renderingwhich helps in diagnosis purpose www.indiandentalacademy.com
  20. 20. Orientation of the scan Maxilla: Parallel to the hard palate Mandible: Parallel to the alveolar ridge or the inferior border of mandible www.indiandentalacademy.com
  21. 21. Marking of points along the ridgewww.indiandentalacademy.com
  22. 22. Paraxial images markings www.indiandentalacademy.com
  23. 23. Panoramic images markings www.indiandentalacademy.com
  24. 24. 3D volume rendering showing loss of 3D volume rendering showing furcation buccal cortical plate in right involvement with left mandibular second molar maxillary first molar region www.indiandentalacademy.com
  25. 25. Present case• . •Access cavity revealed five canals. •Dental CT determined the extend of periapical infection associated with the tooth along with loss of cortical plates , thereby helping in determining the treatment plan & prognosis of the tooth www.indiandentalacademy.com
  26. 26. MAXILLARY SINUS HYPERPLASIA• Hyperplasia of maxillary sinus mucosa was seen, suggesting that periapical infection could be the initiating factor for hyperplasia of mucosa www.indiandentalacademy.com
  27. 27. MULTIPLE EXTRA CANALS• Extra canals were also found in other teeth with periapical infections in lower anterior teeth. www.indiandentalacademy.com
  28. 28. Limitations of Dentascans Cost factor Radiation dose www.indiandentalacademy.com
  29. 29. CONCLUSION•Radiographic examination is an essential part ofdiagnosis in endodontic. Two dimensional imagingcannot depict variations in root canal morphologylike extra canals & the extent of the periapicalinfection. This limitation of two dimensional imagingis overcome by Dentscan. Dentascan in time maychange the way in which the outcome of theendodontic treatment is assessed www.indiandentalacademy.com
  30. 30. REFERENCES• 1: Soraya Robinson, C. Czerny, A. Gahleitner, T. Bernhart and F. M. Kainberger,Dental CT evaluation of mandibular first premolar root configurations and canal variations .Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2002;93:328-32• 2: Schwarz MS, Rothman SL, Rhodes ML, Chafetz N . Computed tomography.• I. Preoperative assessment of the mandible for endosseous implant surgery. Int J Oral Maxillofac Implants 1987 2:137–141• 3: James J. Abrahams: Dental CT Imaging: A Look at the Jaw: Radiology, 2001; 219:334-345.• 4: DelBalso AM, Greiner FG, Licata M. Role of diagnostic imaging in evaluation of the dental implant patient. Radiographics 1994; 14:699-719.• 5: John II, Van TH, Carl EH, Gerald N G, Thomas S, Paul AR, Endodontic cavity preparation.In :Endodontics, Fifth edn. 2002 BC Decker Inc Pg 405-570.• 6: Neaverth EJ, et al. Clinical investigation (in vivo) of endodonticallytreated maxillary first molars. JOE 1987; 10:506• 8: Niemann RW, et al. Dye ingress in molars: furcation to chamber floor. JOE 1993; 19:293• 9: Beatty RG, Krell K.Mandibular molars with five canals: report of two cases. J Am Dent Assoc 1987; 114:802. www.indiandentalacademy.com
  31. 31. REFERENCES• 12: Sierashi SM. Identification and endodontic management of three-canaled maxillary premolars. JOE 1989; 15:29.• 13: Vertucci FJ, Selig A, Gillis R. Root canal morphology of the human maxillary second premolar. Oral Surg 1974;38:456.• 14: Abrahams JJ, Berger SB. Inflammatory disease of the jaw: appearance of reformatted CT scan. AJR Am J Roentgenol 1998;170:1085-91.• 15: Andre Gahleitner,G. Watzek,H. Imhof Dental CT: imaging technique, anatomy and pathologic conditions of the jaws. Eur Radiol 2003 13:366–376 www.indiandentalacademy.com
  32. 32. Thank you www.indiandentalacademy.com

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