26 August 2021

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Case Study #1 - CBCT and the advantages of using 3D radiology

Authors: Prof Dr Daniele Cardaropoli, Dr Alessandro Roffredo

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First of 3 clinical cases in which three-dimensional radiology has allowed us to avoid making diagnostic errors otherwise not evaluable with two-dimensional radiography alone.

First case

The male patient, 57 years old, complains of spontaneous pain and chewing on element 2.6 previously treated endodontically and prosthetically.

The intraoral periapical x-ray performed (Fig. 1) shows a probably incongruous root canal therapy, and the expert eye notes the presence of complex root anatomy in the 2.6. However, there appear to be no endosseous lesions. Nevertheless, the complex anatomy justified executing a CBCT set up with FOV 4x4 and a "Best Quality" program.

The tomographic cuts (Fig. 2 and Fig. 3) showed the presence of an untreated accessory canal and the presence of significant periapical bone resorption not previously noticeable with traditional radiography.

Endodontic retreatment of the element and long-term temporary restoration will then be performed. Finally, a further three-dimensional evaluation performed with the "Quick" program and FOV 4x4 will be required to evaluate the site's healing and proceed with the packaging of the final prosthesis.