INTRODUCTION: To determine the diagnostic hypothesis on the basis of periapical radiography (PR) is a great challenge for radiologists and endodontists. Visualization of three-dimensional structures, available with cone beam computed tomography (CBCT), favors precise definition of the problem and treatment planning. However, metallic artifact effect of intracanal posts might also induce untrue images. The aim of this article is to suggest a map-reading strategy to diagnose root perforations near metallic intracanal posts (ICPs) by using CBCT. METHODS AND RESULTS: The incapacity to locate correctly the position of root perforation might lead to clinical failures. One strategy to minimize metallic artifact in root perforation associated with ICP is to obtain sequential axial slices of each root, with an image navigation protocol from coronal to apical (or from apical to coronal), with axial slices of 0.2 mm/0.2 mm. This map reading provides valuable information showing dynamic visualization toward the point of communication between the root canals and the periodontal space, associated with radiolucent areas, suggesting root perforation. CONCLUSIONS: The accurate management of CBCT images might reveal abnormality that is unable to be detected in conventional PR. A map-reading approach reduces problems related to detection of root perforations near metallic artifacts. The final diagnosis should always be made in conjunction with the clinical findings.
INTRODUCTION: To determine the diagnostic hypothesis on the basis of periapical radiography (PR) is a great challenge for radiologists and endodontists. Visualization of three-dimensional structures, available with cone beam computed tomography (CBCT), favors precise definition of the problem and treatment planning. However, metallic artifact effect of intracanal posts might also induce untrue images. The aim of this article is to suggest a map-reading strategy to diagnose root perforations near metallic intracanal posts (ICPs) by using CBCT. METHODS AND RESULTS: The incapacity to locate correctly the position of root perforation might lead to clinical failures. One strategy to minimize metallic artifact in root perforation associated with ICP is to obtain sequential axial slices of each root, with an image navigation protocol from coronal to apical (or from apical to coronal), with axial slices of 0.2 mm/0.2 mm. This map reading provides valuable information showing dynamic visualization toward the point of communication between the root canals and the periodontal space, associated with radiolucent areas, suggesting root perforation. CONCLUSIONS: The accurate management of CBCT images might reveal abnormality that is unable to be detected in conventional PR. A map-reading approach reduces problems related to detection of root perforations near metallic artifacts. The final diagnosis should always be made in conjunction with the clinical findings.
Authors: Regis Augusto Aleixo Alves; João Batista Souza; Ana Helena Gonçalves Alencar; Jesus Djalma Pécora; Carlos Estrela Journal: Iran Endod J Date: 2013-10-07
Authors: Orlando Aguirre Guedes; Marcus Vinícius Corrêa da Costa; Maura Cristiane Gonçales Orçati Dorilêo; Helder Fernandes de Oliveira; Fábio Luis Miranda Pedro; Matheus Coelho Bandeca; Álvaro Henrique Borges Journal: J Int Oral Health Date: 2015-03
Authors: Carla Cristina Camilo; Manoel Brito-Júnior; André Luis Faria-E-Silva; Alex Carvalho Quintino; Adrianne Freire de Paula; Antônio Miranda Cruz-Filho; Manoel Damião Sousa-Neto Journal: Case Rep Dent Date: 2013-03-31