Extensive resorption better visualized on CBCT than on 2D X-ray

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Untreated canals

A root canal was done on # 30 last fall.  The tooth continued to be symptomatic.  The Periapical X-ray didn’t show the cause of the problem.  Axial and Coronal views are not available on 2D intraoral x-rays.  Cone Beam CT shows that there were untreated canals in both the mesial and distal roots.

“The best way to show that a stick is crooked is not to argue about it or to spend time denouncing it, but to lay a straight stick along side it.” D L Moody

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Post Prep Perforation

This is a 7 year old root canal with swelling and some pain.  Periapical X-ray only showed a lesion, Cone Beam CT showed a buccal perforation by the post prep.

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Detecting cracked root on Cone Beam CT

No obvious bone loss on Periapical X-ray; obvious bone loss on CBCT consistent with vertical root fracture over 7 mm below crest of bone.  

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Cracked Palatal root upper molar

Periapical X-ray showed a lesion possibly associated the the mesial buccal root of this upper molar.
Cone Beam CT clearly shows that the palatal root is fractured.

Cone Beam CT shows palatal root fractured

Periapical X-ray shows lesion upper first molarCone Beam CT shows palatal rootCone Beam CT shows palatal root fractured

fracturedCone Beam CT shows palatal root fractured

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Internal resorption

possible resorption # 14

Internal resorption palatal root # 14

This case illustrates the value of Cone Beam CT in evaluating the location and extent of resorptive defects in teeth.The Periapical X-ray hints at the lesion but the CBCT clearly shows the location and size.

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Avulsed Lower incisors

Our medical colleagues get very little dental training.  This 26 year old dental assistant fell and knocked out her lower left central and lateral incisors.  She went to the ER where the physician reimplanted the teeth.  Her dentist had to adjust the occlusion because her bite was off.  Periapical X-ray showed slight lesions but Cone Beam CT clearly showed the teeth were not in their original sockets but between the buccal plate and soft tissue.  If she had been seen by a dentist originally, the might have been reimplanted in the sockets.

2D Periapical x-ray

# 24 viewed from Mesial

# 23 viewed from mesial

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Reinfected lower molar with previous apicoectomy.

Here is a case that clearly shows the amount of bone loss around a lower first molar with a previous apicoectomy. Note the extend of bone loss, the angle of the bevel, the lack of  a retrofill.  The Periapical X-ray didn’t reveal any of that.

Cone Beam CT lower molar apicoVertical Bitewing

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