Goals: CT enables periapical disease and endoperiodontal syndrome to be revealed by radiolucent changes at the root apex at an earlier stage than on conventional radiographs. Material and method. The accuracy of CBCT images to identify anatomic and pathologic alterations compared to panoramic and periapical radiographs has been shown to reduce the incidence of false-negative results. We used cone-beam computed tomography (CBCT) with a flatpanel detector to diagnose a group of 36 patients with endo-periodontal lesions, instead of using standard retrodental radiographs. Only one CT and one retro-dental radiograph were performed for each patient. Results and discussions: Earlier treatment of the endoperiodontal syndrome is more successful, that is before obvious radiographic signs of periapical and periodontal alterations. Thus, earlier detection of radiolucent changes should result in earlier identification and better management
of the disease. Of a total of 21 cases of apparently endodontic origin, CBCT showed that 63% were in fact of combined origin and only 37% of pure endodontic origin. While the standard retro-dental radiographs revealed 47% of the endo-periodontal lesions to be of true combined nature, the cone-beam CT discriminated only 21.2% belonging to that category, 37.6% having as primary source a periapical lesion and 41.2% having as primary source a periodontal lesion. Of a total of 21 cases of apparently endodontic origin, CBCT showed that 63% were in fact of combined origin and only 37% of pure endodontic origin. Conclusion: Crucial and essential information of the three-dimensional anatomy of the tooth/teeth and the periodontal tissue anatomy is obscured, and even with the best intentions and paralleling techniques, distortion and superimposition of dental structures in periapical views are unavoidable.
- CT examination
- endo-periodontal syndrome
- periapical radiographs