Denta scans in endodontics /certified fixed orthodontic courses by Indian dental academy

DENTASCANS IN ENDODONTICS

INDIAN DENTAL ACADEMY
Leader in Continuing Dental Education

www.indiandentalacademy.com

Contents

• Introduction
• Case Report.
• Discussion.
• Conclusion.
• References.


PROPER TREATMENT

ACCESS CAVITY OBTURATION RESULT


FAILURE

ANATOMIC
VARIATIONS FAILURE


CONVENTIONAL IMAGING
TECHNIQUES

PERIAPICAL RADIOGRAPHS
PANORAMIC RADIOGRAPHS

1: EASY
2:ECONOMICAL

LACK OF PERCEPTION IN THIRD DIMENSION


DENTASCANS
• Dentascan, was developed by Schwarz
et al. in 1987

Schwarz MS, Rothman SL, Rhodes ML, Chafetz N . Computed tomography.
I. Preoperative assessment of the mandible for endosseous implant surgery. Int J Oral Maxillofac Implants 1987 2:137–141

DENTASCANS PRIMARY
INDICATIONS

Pre-evaluation of implant sites

Buccolingual extent of cysts and tumours

Inflammatory lesions of the jaws


CASE
REPORT

• 45 yr male patient
• Chief complaint : Swelling in right side
of face.
• Medical history was not significant.
• Badly carious maxillary right first molar
with obliteration of buccal vestibule


IOPA


Extra canals in right maxillary molars Extra canals in maxillary left first and second molars


Axial image showing extra canals in
multiple teeth


: Axial image showing loss of cortical plate in
distobuccal and palatal root of 3D image showing loss of palatal and
right maxillary first molar buccal cortical plate


Paraxial image of maxillary first molar
showing MB root
with periapical infection
with maxillary sinus inflammation


3D volume rendering showing loss of 3D volume rendering showing furcation
buccal cortical plate in right
involvement with left mandibular second molar
maxillary first molar region


Mandibular anterior region showing periapical
infection with loss of labial cortical plates


LIMITATIONS OF TWO
DIMENSIONAL IMAGING

•Extra canals are a common findings and
missing of these canals leads to endodontic
treatment failure.

•Intra oral radiographs - anatomy in the
third dimension cannot be assessed


Root canals tend to lie one behind the
other in buccolingual plane, they get
superimposed onto each other on
periapical & panoramic radiographs
and easily go undetected

Soraya Robinson, C. Czerny, A. Gahleitner, T. Bernhart and F. M. Kainberger
,Dental CT evaluation of mandibular first premolar root configurations and canal variations .
Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2002;93:328-32

Dental CT : An
alternative

•Dental CT is reformatting software
used along with spiral /helical CT and
allows assessment in all three
dimensions.

•It provides axial, panoramic,
paraxial and 3D volume rendering
which helps in diagnosis purpose

Orientation of the scan

Maxilla:
Parallel to the
hard palate

Mandible:
Parallel to the
alveolar ridge or
the inferior border
of mandible


Marking of points
along the ridge


Paraxial images
markings


Panoramic images
markings


Present case
• .
•Access cavity revealed five canals.
•Dental CT determined the extend of
periapical infection associated with the
tooth along with loss of cortical plates ,
thereby helping in determining the
treatment plan & prognosis of the tooth


MAXILLARY SINUS HYPERPLASIA

• Hyperplasia of maxillary sinus mucosa
was seen, suggesting that periapical
infection could be the initiating factor for
hyperplasia of mucosa


MULTIPLE EXTRA CANALS

• Extra canals were also found in other
teeth with periapical infections in lower
anterior teeth.


Limitations of Dentascans

Cost factor

Radiation dose


CONCLUSION

•Radiographic examination is an essential part of
diagnosis in endodontic. Two dimensional imaging
cannot depict variations in root canal morphology
like extra canals & the extent of the periapical
infection. This limitation of two dimensional imaging
is overcome by Dentscan. Dentascan in time may
change the way in which the outcome of the
endodontic treatment is assessed


REFERENCES
• 1: Soraya Robinson, C. Czerny, A. Gahleitner, T. Bernhart and F. M. Kainberger,Dental CT
evaluation of mandibular first premolar root configurations and canal variations .Oral Surg Oral
Med Oral Pathol Oral Radiol Endod 2002;93:328-32
• 2: Schwarz MS, Rothman SL, Rhodes ML, Chafetz N . Computed tomography.
• I. Preoperative assessment of the mandible for endosseous implant surgery. Int J Oral
Maxillofac Implants 1987 2:137–141
• 3: James J. Abrahams: Dental CT Imaging: A Look at the Jaw: Radiology, 2001; 219:334-345.
• 4: DelBalso AM, Greiner FG, Licata M. Role of diagnostic imaging in evaluation of the dental
implant patient. Radiographics 1994; 14:699-719.
• 5: John II, Van TH, Carl EH, Gerald N G, Thomas S, Paul AR, Endodontic cavity
preparation.In :Endodontics, Fifth edn. 2002 BC Decker Inc Pg 405-570.
• 6: Neaverth EJ, et al. Clinical investigation (in vivo) of endodonticallytreated maxillary first
molars. JOE 1987; 10:506
• 8: Niemann RW, et al. Dye ingress in molars: furcation to chamber floor. JOE 1993; 19:293
• 9: Beatty RG, Krell K.Mandibular molars with five canals: report of two cases. J Am Dent
Assoc 1987; 114:802.


REFERENCES
• 12: Sierashi SM. Identification and endodontic management of
three-canaled maxillary premolars. JOE 1989; 15:29.
• 13: Vertucci FJ, Selig A, Gillis R. Root canal morphology of the
human maxillary second premolar. Oral Surg 1974;38:456.
• 14: Abrahams JJ, Berger SB. Inflammatory disease of the jaw:
appearance of reformatted CT scan. AJR Am J Roentgenol
1998;170:1085-91.
• 15: Andre Gahleitner,G. Watzek,H. Imhof Dental CT: imaging
technique, anatomy and pathologic conditions of the jaws. Eur
Radiol 2003 13:366–376


Thank you

Denta scans in endodontics /certified fixed orthodontic courses by Indian dental academy

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