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Surgical Treatment Utilizing Cone Beam Computed Tomography

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3D Imaging in Endodontics

Abstract

Cone beam computed tomography (CBCT) is a diagnostic imaging modality that provides a high-quality, dimensionally accurate three-dimensional (3D) representation of the osseous elements of the maxillofacial skeleton. CBCT has the potential to transform the practice of endodontic microsurgery, much in the same way that other new technologies introduced over the past two decades—such as microscopes, ultrasonic devices, and new root-end filling materials—have led to enhanced safety and treatment outcomes. The different applications of CBCT in diagnosis, treatment planning, and long-term outcome evaluation of periapical surgery will be reviewed. In this chapter, cases will be presented to demonstrate the value of CBCT imaging in presurgical assessment, case selection, and treatment planning in endodontic microsurgery. The use of CBCT to identify and manage cases involving close proximity to important anatomical structures (e.g., maxillary sinus, the inferior alveolar, mental, and nasopalatine neurovascular bundles) and to evaluate the outcome of periapical microsurgery will be presented and discussed.

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References

  1. Cheung G, Wei WLL, McGrath C. Agreement between periapical radiographs and cone-beam computed tomography for assessment of periapical status of root filled molar teeth. Int Endod J. 2013;46:889–95.

    Article  PubMed  Google Scholar 

  2. Esposito S, Huybrechts B, Slagmolen P, Cotti E, Coucke W, Pauwels R, Lambrechts P, Jacobs R. A novel method to estimate the volume of bone defects using cone-beam computed tomography: an in vitro study. J Endod. 2013;39(9):1111–5.

    Article  PubMed  Google Scholar 

  3. Bornstein MM, Lauber R, Sendi P, von Arx T. Comparison of periapical radiography and limited cone-beam computed tomography in mandibular molars for analysis of anatomical landmarks before apical surgery. J Endod. 2011 Feb;37(2):151–7.

    Article  PubMed  Google Scholar 

  4. Low MTL, Dula KD, Bürgin W, von Arx T. Comparison of periapical radiography and limited cone-beam tomography in posterior maxillary teeth referred for apical surgery. J Endod. 2008;34:557–62.

    Article  PubMed  Google Scholar 

  5. Tsai P, Torabinejad M, Rice D, Azevedo B. Accuracy of cone-beam computed tomography and periapical radiography in detecting small periapical lesions. J Endod. 2012;38:965–70.

    Article  PubMed  Google Scholar 

  6. Tyndall DA, Rathore S. Cone-beam diagnostic applications: caries, periodontal bone assessment, and endodontic applications. Dent Clin N Am. 2008;52:825–41.

    Article  PubMed  Google Scholar 

  7. Cotton TP, Geisler TM, Holden DT, Schwartz SA, Schindler WG. Endodontic applications of cone-beam volumetric tomography. J Endod. 2007;33:1121–32.

    Article  PubMed  Google Scholar 

  8. Velvart P, Hecker H, Tillinger G. Detection of the apical lesion and the mandibular canal in conventional radiography and computed tomography. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2001 Dec;92(6):682–8.

    Article  PubMed  Google Scholar 

  9. Rigolone M, Pasqualini D, Bianchi L, Berutti E, Bianchi SD. Vestibular surgical access to the palatine root of the superior first molar: “low-dose cone-beam” CT analysis of the pathway and its anatomic variations. J Endod. 2003;29:773–5.

    Article  PubMed  Google Scholar 

  10. Maillet M, Bowles WR, McClanahan SL, John MT, Ahmad M. Cone-beam computed tomography evaluation of maxillary sinusitis. J Endod. 2011;37(6):753–7.

    Article  PubMed  Google Scholar 

  11. Bornstein MM, Wasmer J, Sendi P, Janner SF, Buser D, von Arx T. Characteristics and dimensions of the Schneiderian membrane and apical bone in maxillary molars referred for apical surgery: a comparative radiographic analysis using limited cone beam computed tomography. J Endod. 2012 Jan;38(1):51–7.

    Article  PubMed  Google Scholar 

  12. Kovisto T, Mansur Ahmad M, Bowles W. Proximity of the mandibular canal to the tooth apex. J Endod. 2011;37(3):311–5.

    Article  PubMed  Google Scholar 

  13. Bürklein S, Carolin Grund C, Schäfer E. Relationship between root apices and the Mandibular Canal: a cone-beam computed tomographic analysis in a German population. J Endod. 2015 Oct;41(10):1696–700.

    Article  PubMed  Google Scholar 

  14. Lofthag-Hansen S, Huumonen S, Grondahl K, Grondahl H-G. Limited cone-beam CT and intraoral radiography for the diagnosis of periapical pathology. Oral Surg Oral Med Oral Pathol Oral Radiol Endodontol. 2007;103:114–9.

    Article  Google Scholar 

  15. Simon JHS, Enciso R, Malfaz J-M, Roges R, Bailey-Perry M, Patel A. Differential diagnosis of large periapical lesions using cone-beam computed tomography measurements and biopsy. J Endod. 2006 September;32(9):833–7.

    Article  PubMed  Google Scholar 

  16. Bornstein MM, Bingisser AC, Reichart PA, Sendi P, Bosshardt DD, von Arx T. Comparison between radiographic (2-dimensional and 3-dimensional) and histologic findings of periapical lesions treated with apical surgery. J Endod. 2015 Jun;41(6):804–11.

    Article  PubMed  Google Scholar 

  17. De Paula-Silva FW, Junior MS, Leonardo MR, Consolaro A, daSilva LA. Cone-beam computerized tomographic, radiographic, and histologic evaluation of periapical repair in dogs’ post-endodontic treatment. Oral Surg Oral Med Oral Pathol Oral Radiol Endodontol. 2009b;5:796–805.

    Article  Google Scholar 

  18. Kourkouta S, Bailey G. Periradicular regenerative surgery in a maxillary central incisor: 7-year results including cone-beam computed tomography. J Endod. 2014;40(7):1013–9.

    Article  PubMed  Google Scholar 

  19. Christiansen R, Kirkevang LL, Gotfredsen E, Wenzel A. Periapical radiography and cone beam computed tomography for assessment of the periapical bone defect 1 week and 12 months after root-end resection. Dentomaxillofac Radiol. 2009 Dec;38(8):531–6.

    Article  PubMed  Google Scholar 

  20. Von Arx T, Janner SF, Hänni S, Bornstein MM. Agreement between 2D and 3D radiographic outcome assessment one year after periapical surgery. Int Endod J. 2015;1-11:915.

    Google Scholar 

  21. Tanomaru-Filho M, Jorge EG, Guerreiro-Tanomaru JM, Reis JM, Spin-Neto R, Goncalves M. Two- and tridimensional analysis of periapical repair after endodontic surgery. Clin Oral Investig. 2015;19:17–25.

    Article  PubMed  Google Scholar 

  22. Bueno MR, Estrela C, Azevedo BC, Diogenes A. Development of a new cone-beam computed tomography software for endodontic diagnosis. Braz Dent J. 2018;29:517–29.

    Article  PubMed  Google Scholar 

  23. Bharathi J, Mittal S, Tewari S, Tewari S, Duhan J, Sangwan P, Kumar V. Effect of the piezoelectric device on intraoperative hemorrhage control and quality of life after endodontic microsurgery: a randomized clinical study. J Endod. 2021;47(7):1052–60.

    Article  PubMed  Google Scholar 

  24. Niemczyk SP, Barnett F, Johnson JD, Ordinola-Zapata R, Glinianska A, Bair J, Jang J-H, Sungmin A. PRESS and Piezo Microsurgery (Bony Lid): A 7-year evolution in a residency program part 1: surgeon-defined Site Location. J Endod. 2022;48(6):787–796.e2.

    Article  PubMed  Google Scholar 

  25. Niemczyk SP, Barnett F, Johnson JD, Ordinola-Zapata R, Glinianska A, Bair J, Jang J-H, Sungmin A, Andrew V. PRESS and Piezo Microsurgery (Bony Lid): a 7-year evolution in a residency program—Part 2: PRESS-defined site location. J Endod. 2022;48(6):797–806.e2.

    Article  PubMed  Google Scholar 

  26. Vasudevan A. Dynamic navigation in guided endodontics–a systematic review. European Endodontic J. 2022;7(2):81–91.

    Google Scholar 

  27. Aldahmash Sara A, Price Jeffery B, Mostoufi B, Griffin Ina L, Dianat O, Tordik Patricia A, Martinho FC. Real-time 3-dimensional dynamic navigation system in endodontic microsurgery: a cadaver study. J Endod. 2022;48(7):922–9.

    Article  PubMed  Google Scholar 

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Correspondence to Mohamed I. Fayad .

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Fayad, M.I., Johnson, B.R. (2023). Surgical Treatment Utilizing Cone Beam Computed Tomography. In: Fayad, M.I., Johnson, B.R. (eds) 3D Imaging in Endodontics. Springer, Cham. https://doi.org/10.1007/978-3-031-32755-1_7

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  • DOI: https://doi.org/10.1007/978-3-031-32755-1_7

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  • Publisher Name: Springer, Cham

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  • Online ISBN: 978-3-031-32755-1

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