The use of cone beam computed tomography in the field of endodontics

CBCT (Cone Beam Computed Tomography ) radiological imaging in dentistry is a three-dimensional display of the teeth, jaws and surrouding anatomical structures of the head and neck. This type of diagnostics provides insight into the third dimension and is used in all areas of dentistry. This makes therapy planning easier, as well as the prognosis of a given disease. The operating principle of the CBCT device is based on directing cone beams to a narow imaging field. By reducing the area exposed to radiation, the effective radiation dose is reduced compared to conventional computed tomography (CT). CBCT imaging allows for high differentation of details and is economical and easy to use. CBCT imaging lasts very short, only 30 seconds, during which one circular rotation around the patient's head occurs. The data obtained through modern software is compressed into a three-dimensional image, which the therapist can analyze in coronal, axial and sagital sections. Point, angle and working length for root canal treatment, reducing the risk of procedural errors. CBCT can also help identify additional canals of apical branches that may be missed by traditional imaging techniques, ensuring the cleaning and shaping of the root canal system of the tooth.

CBCT can by used in endodontic treatment of emergencies, such as dental trauma or acute infections. CBCT images can help therapists to asses the extent of tooth and bone damage, detect fractures, and assess the relationship between the apex of the tooth root and adjacent anatomical structures, such as the nasal cavity or maxillary sinus. The National Institutes of Health recommends CBCT imaging as an appropriate approach to treatment and to predict the prognosis of dental therapy. THE USE OF CONE COMPUTED TOMOGRAPHY IN ENDODONTICH – Aleksandra Đeri 2 The Radiological Society of North America (RSNA) indicates that CBCT diagnostics provide the therapist with better knowledge and perception of the existing disease. When we have the possibility of three-dimensional imaging of teeth, we also have the possibillity of better and more successful therapy planning. It should be borne in mind that the human visual system has its advantages but also limitations, so the coignitive abilities of the therapist are also one of the factors on which the accuracy of the reading of the CBCT image will depend. Modern digital radiographic imaging systems are used today in edodontic treatment of teeth, whether preoperatively, intraoperatively or postoperatively. Certainly, the support of CBCT diagnostics significantly improves insight into the disease problem an then the decision on the diagnosis and treatment plan. Image quality is very important in endodontics because it facilitates precise interpretation of endodontic anatomy, especiallly the detection of possible canal curvatures, as well as postoperative evaluation and long–term outcome of endodontic treatment. CBCT has enabled a detailed three-dimensional assesment of teeth, the maxillofacial skeleton, and the relationships between anatomical structures. CBCT in endodontics provides not only a three-dimensional assesment of the region of interest, but also an appropriate image resolution that allows for detailed analysis of the anatomy of the tooth and the surrounding alveolus. The European Society of Endodontology (ESE) guidelines suggest the use of CBCT in endodontics in limited cases as follows: 1. Diagnosis of periapical pathology in the presence of contradictory (non-specific) signs      and/orsymptoms 2. Confirm the cause of non-odontogenic pathology 3. Evaluation of maxillofacial trauma and/or quality of treatment 4. Highly complex assesment of root canal anatomy before endodontic orthograde treatment 5. Assesment of the cause of endodontic failure in planning surgical endodontic treatment

6. Evaluation and/or treatment of root canal resorption.