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Endo discussions
 CBCT mesiolingual canal validation
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From: Terry Pannkuk
To: ROOTS
Sent: Wednesday, May 12, 2010 4:20 PM
Subject: [roots] Another CBCT mesiolingual canal validation
I’m thinking of scanning every short MB2 I get to validate the management of the anatomy.
This patient was a very petite woman with extremely challenging access to the maxillary second molar.
The endo lit seems to suggest a much smaller percentage of MB2’s than I see (lit appx. 35%, in reality
I see 67% according to my own statistics). Mismanagment of short MB2 or mesiolingual canal is common
place and if a CT is available and convenient it’s very nice to validate the management. I happened to
take a preop CT on this patient to look at bicuspid which was suspected of being fractured, It is to
be retreated next. It was initially treated somewhere else. The preop scan gave me a unique opportunity
to show the mesiobuccal root preop and postoperatively. I wouldn’t’ have necessarily assumed there was
a short MB2 from the preop CBCT and I don’t think there is a much value in routinely scanning teeth to
predetermine anatomy until the resolution advances in CBCT technology. It’s not there yet.
It is fascinating to see the anatomy after the fact when it’s filled with something radiopaque.
I think it would be inappropriate to charge the patient for this though.
First Question: Did taking a preop CBCT scan help me find all the canals and treat this case?
Second Question: Did taking a postop CBCT scan help validate and confirm that the short MB2 system
wasn’t iatrogenic mismanagement?
The value of the CBCT most frequently helps with validation, not execution, which begs the question,
How many clinicians are going to use this technology routinely and sell it to patients claiming that
it is providing help during treatment; when in fact, it is primarily demonstrating what has already
been done? Get ready for CT scaming; it will be coming to your town. J
I attached the conventional PA’s and treatment photos.
These are the interesting captures preoperatively - Terry Pannkuk
These are the interesting captures showing the obturation result:
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