Conventional 2 D x-ray imaging is excellent for diagnosing, say, the extent of caries, and many other dental problems. Those two-dimensional x-ray images are, however, not ideal material for the endodontist to really judge the state of the root canals and root tip area: Structures located at different depths inside the tooth are pictured in a superimposed way, and “shadows” from the surroundings of the tooth further reduce clarity. As a result, the image lacks contrast and definition, and it cannot convey important spatial information.
3D X-ray provides high definition, detail and depth
Cone Beam Computed Tomography (CBCT or 3D x-ray, in short) has overcome these
limitations: Each recording produces a set of crisp two-dimensional images from
different planes (cross sections) of the tooth that may be combined into three-
dimensional representations. This form of imaging provides much more information
than conventional x-ray pictures.
Thus, there are many cases in endodontic practice when the comparatively higher
expense of a 3 D x-ray recording is clearly offset by the benefits afforded by its superior
quality – e.g. when judging whether an extensively diseased or fractured tooth is worth
preserving. From such images, we can assess exactly where and to what extent the root
is fractured or fissured, and whether root or jaw bone show any signs of the tissue
resorption often caused by advanced inflammation.
Superior diagnostics – better therapeutic decisions
With 3D x-ray, we can reliably assess the probability of a favorable outcome of
endodontic therapy. Thus, we are in the best position to decide whether to start
treatment (and advantageously use the information gained from the images to plan our
approach) – or save our patients the time and expense of a futile treatment attempt and
suggest a different solution, like an implant, instead.