Cone Beam Computed Tomography We are excited to introduce Cone Beam Computed Technology (CBCT) to our office, and would like to give you a little introduction as to why we decided to bring this type of medical imaging into our practice as endodontists. This technology allows us to take small field of view (specific to endodontics) 3-D CT scans for our patients to make endodontic evaluation and treatment more efficient and effective. CBCT is becoming more and more the standard of care for various types of cases we treat, and we are excited to incorporate this into our practice.
The AAE and American Academy of Oral and Maxillofacial Radiology issued a joint position statement in 2015 with specific recommendations and supporting evidence of when the CBCT should be considered, and when it should be routinely used as the standard of care. It is now recommended prior to EVERY endodontic retreatment and endodontic surgery, but it also is recommended when the patient is presenting with non-specific or contradictory clinical signs, or if we are suspicious of a vertical root fracture or sinus issue. As root canal specialists, these complex cases are referred to our office every day. A CBCT is recommended pre-operatively when the clinician is suspicious of complex anatomy (maxillary molars, or even mandibular anteriors that may have multiple canals). It really helps when we can look at a scan ahead of time for guidance on what we are looking for and where.
Taking a CBCT takes about 30 seconds, and interpretation can be done chairside by the endodontist. Unlike a conventional CT scan, we are utilizing a small field of view exposure, which allows us to see 2-5 teeth in the area of interest, with minimal radiation (less than one bitewing radiograph) and exceptional clarity.
Most of the time the CBCT is taken preoperatively to evaluate for a lesion that might not be clear on a 2D film, possible missed canals in an existing root canal, location of calcified canals, or resorptive lesions, but occasionally we take a CBCT mid-appointment to help guide us in our access to help conserve more tooth structure when looking for canals. The CBCT does not typically show an actual fracture line in a tooth, but frequently it helps us see a pattern of bone loss around a fracture that allows us to be pretty confident in our diagnosis, where a 2D film might not show evidence of this.
We are proud to continue serving you by practicing to the standard of care, and staying up to date on the latest guidelines to make sure you are given the best care possible.