The Essential Dental Tool: CT Scan

Laura Wittenauer, DDSWhen patients come to us with vague symptoms, it makes the etiology for their pain difficult to locate.  Working with an endodontist using cone beam technology can be very beneficial to your diagnosis of these patients pain.

Identifying the Pain
Friend, in the Journal of Endodontics, indicated that only 37% of patients can accurately determine the source of their odontogenic pain.  Referred pain is very common due to convergence of the pain producing neurons to the same second order terminals in the nucleus caudalis. This convergence can make it very frustrating for both us and the patient when no positive identification of the offending tooth is isolated.

Radiograph Limitations
Seltzer and Bender in 1961 determined that lesions of endodontic origin must perforate or significantly thin the buccal cortical plate to be visible on the radiograph.  And when the infection is contained solely in the cancellous bone, the lesion is not visible on the radiograph.

CT Scan Advantages
Lo in the endodontic literature proved that the CT scan shows more periapical pathology than 2-D radiographs. In most instances, a periapical x-ray can show small changes in the bone, but the CT images can show a lesion of significant size and provide you with the exact source of the problem.  This trait makes the CT scan a great tool.

The CT scan is also very helpful in dental retreatment cases in determining if a tooth is restorable.  The scan can show root fractures, bone loss and missed canals.

Overall, the CT allows your endodontist to be more thorough in their diagnosis which leads to enhanced diagnostics and ultimately providing the best treatment for your patients. If your endodontist is not using cone beam technology, encourage them to investigate the benefits in the dental treatment of your patients.

 

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