Diagnosis and decision making in endodontics with the use of cone beam computed tomography

In the current thesis the use of cone beam computed tomography (CBCT) in endodontics has been evaluated within the framework of ex vivo and in vivo studies.
The first objective of the thesis was to examine whether CBCT scans can be used for the detection of vertical root fractures in endodontically treated teeth. The results of two ex vivo and one in vivo studies support the use of CBCT scans for the detection of vertical root fractures in endodontically treated teeth. They also suggest that the reproducibility and accuracy in vertical root fracture detection depend on the CBCT system used.
The second objective was to follow the volumetric changes of periapical radiolucencies in endodontically treated teeth one year after orthograde retreatment with the use of CBCT scans. The volume of periapical radiolucencies reduced in 57% teeth, remained unchanged in 23% and increased in 20%.
The third objective was to compare the precision of root canal length measurement on CBCT scans and periapical radiographs and to examine the influence of tooth type on these measurements. Root canal length measurements of posterior maxillary teeth were more accurate on CBCT images than periapical radiographs.
The present thesis does not suggest that CBCT scans should replace the periapical radiographs for every endodontic patient. It rather emphasizes the need for careful patient selection together with the most suitable CBCT system and settings. Furthermore, it points out the importance of making the best use of available pre-existing CBCT scans before a patient is treated.