3D Imaging in Endodontics (eBook)

Mohamed I. Fayad, BDS, MS, PhD, is Assistant Clinical Professor in the College of Dentistry – University of Illinois at Chicago, Chicago, USA. Dr. Fayad graduated from the Faculty of Oral and Dental Medicine, Cairo University, Egypt in 1985 and subsequently gained his Masters and Doctorate in Endodontics from the same university. He completed further postgraduate studies in the Department of Endodontics, College of Dentistry, University of Illinois before joining the Department professionally in 2000. Since that time his private practice has been limited to endodontics. Dr. Fayad is a Diplomate of the American Board of Endodontists. From 2004 to 2006 he was a member of the Research and Scientific Affairs Committee of the American Association of Endodontists and in 2013–2014 he served as President of the Illinois Association of Endodontists. He is also a past president of the Edgar D. Coolidge Endodontic Study Club. Dr. Fayad has given many scientific presentations at national and international meetings and is the author of 16 articles in peer-reviewed journals.Bradford R. Johnson, DDS, MHPE, is Head of the Department of Endodontics, College of Dentistry – University of Illinois at Chicago, Chicago, USA, where he is an Associate Professor and Director of Postdoctoral Endodontics. Dr. Johnson has engaged in clinical practice limited to endodontics since 1991 and is proficient in all phases of nonsurgical and surgical endodontics. He is a Diplomate of the American Board of Endodontics, a Fellow of the American Dental Education Association Leadership Institute, a Fellow of The Odontographic Society of Chicago, and a Fellow of the International College of Dentists. Dr. Johnson is a Director and board member of the American Association of Endodontists (2015–2018), and a past chair of their Evidence-Based Endodontics Committee (2009–11) and Research and Scientific Affairs Committee (2002–3). He has also been President of the Illinois Association of Endodontists (2002–3) and the Edgar D. Coolidge Endodontic Study Club (2007–8). Dr. Johnson has been a member of the Scientific Advisory Panel of the Journal of Endodontics since 2003. He is the author of more than 30 articles in peer-reviewed journals.

Preface and Acknowledgments 6
Contents 8
1: Principles of Cone Beam Computed Tomography 9
1.1 Introduction 9
1.1.1 What Is Computed Tomography? 10
1.2 CBCT Image Acquisition 10
1.2.1 X-Ray Source and Exposure Settings 10
1.2.2 Image Detector 11
1.2.3 Number of Basis Projections 11
1.2.3.1 Extent of the Rotation Arc (180° vs. 360°) 12
1.2.3.2 “Quick Scan” and “Fast Scan” Imaging Modes 12
1.2.3.3 “High-Resolution” Scan Mode 12
1.2.3.4 Field of View (FOV) 13
1.2.3.5 Voxel Size 14
1.3 CBCT Artifacts 14
1.4 Radiation Dose Considerations 15
1.4.1 Risks from Diagnostic Radiation 16
1.4.1.1 Deterministic Effects 16
1.4.1.2 Stochastic Effects 16
1.4.2 Estimating Radiation Doses from Dento-maxillofacial CBCT 17
1.4.3 Conveying Radiation Risks to Patients 18
1.4.4 Methods to Minimize Patient Radiation Exposure from CBCT Examinations 20
1.4.4.1 Selection Criteria 20
1.4.4.2 Optimization of Imaging Protocols 21
1.4.4.3 Protective Aprons and Thyroid Collars 21
References 21
2: Utilization of Cone Beam Computed Tomography in Endodontic Diagnosis 23
2.1 Introduction 23
2.2 Detection of Periapical Lesions 24
2.3 Differential Diagnosis of Pain When Etiology Is Unclear and Identification of Unusual Anatomical Relationships 25
2.4 Detection of Cracked Teeth and Root Fractures 29
2.5 Detection and Diagnosis of Inflammatory Resorptive Defects 35
2.6 Traumatic Dental Injuries (TDI) 36
Conclusion 38
References 39
3: The Impact of Cone Beam Computed Tomography in Nonsurgical and Surgical Treatment Planning 41
3.1 Introduction 42
3.2 Implications for Clinical Practice 43
Conclusion 44
References 58
4: Three-Dimensional Evaluation of Internal Tooth Anatomy 60
4.1 Introduction 60
4.2 Methods for Studying Tooth Anatomy 61
4.3 Clinical Methods for the Evaluation of Tooth Anatomy 63
4.3.1 Common Tooth Forms and Anatomical Landmarks 63
4.3.2 Endodontic Access Design 65
4.3.3 Evaluation of Complex Roots and Root Canal Variations 66
4.4 Maxillary Molar Teeth 67
4.4.1 The Mesiobuccal Root Complex 67
4.4.2 Multiple Palatal Roots and Canals 67
4.5 Mandibular Molar Teeth 67
4.5.1 Radix Entomolaris and Radix Paramolaris 67
4.5.2 C-Shaped Canal 69
4.5.3 Isthmus Canals 69
4.6 Maxillary Premolar Teeth 70
4.7 Mandibular Premolar Teeth 71
4.8 Mandibular Incisor Teeth 72
4.9 Additional Anatomic and Morphologic Considerations 72
4.9.1 Dens Invaginatus 72
4.9.2 Accessory Canals 73
4.9.3 Position of the Apical Foramen 77
4.9.4 Canal Confluence 77
Conclusion 78
References 79
5: Nonsurgical Retreatment Utilizing Cone Beam Computed Tomography 81
5.1 Case #1 86
5.2 Case #2 88
5.3 Case #3 91
5.4 Case #4 95
5.5 Case #5 98
5.6 Case #6 102
5.7 Case #7 105
5.8 Case #8 108
5.9 Case #9 110
5.10 Case #10 113
5.11 Case #11 115
References 117
6: Surgical Treatment Utilizing Cone Beam Computed Tomography 119
6.1 Potential Applications of CBCT in Treatment Planning of Endodontic Microsurgery 119
References 135
7: The Use of CBCT in the Diagnosis and Management of Root Resorption 137
7.1 Introduction 138
7.2 CBCT: Serial Cross-Sectional Imaging 138
7.3 CBCT: Volume Size, Spatial Resolution, and Radiation Dose 139
7.4 External Root Resorption 139
7.5 Internal Root Resorption 142
Conclusion 147
References 147
AAE and AAOMR Joint Position Statement 150