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Endo tips    Better Endo    Endo abstracts    Endo discussions

CBCT mesiolingual canal validation

The opinions and photographs within this web page are not ours. Authors have been credited
for the individual posts where they are.

From: Terry Pannkuk
Sent: Wednesday, May 12, 2010 4:20 PM
Subject: [roots] Another CBCT mesiolingual canal validation

Iím 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 MB2ís 
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 
itís 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'ítí have necessarily assumed there was a short MB2 from the 
preop CBCT and I donít think there is a much value in routinely 
scanning teeth to predetermine anatomy until the resolution 
advances in CBCT technology. Itís not there yet. It is fascinating 
to see the anatomy after the fact when itís 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 wasnít 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 PAís and treatment photos.

These are the interesting captures preoperatively - Terry Pannkuk

These are the interesting captures showing the obturation result:

Thermafil removal
Orthognath case
2 fractured instruments
3 BM canals
Confluent canals
Clean premolar
Sensitive to percussion
7 canals lower molar
Sinus implant
When to use MTA?
Hess anatomy
Rare surgery
Molar EICR
Hyperaemic pulp
Palatal fracture
MB2,MB3,DB & DB2
Two mini molars
Amalgam replacement
Little mouth opening
Perio pockets
Apical abscess
4 canals lower molar
Glass fiber post
Tooth #8 and #9
Pulp piercing
Restorative failure
Tooth #18 Pulp test
CBCT perf repair
12 year recall
Probable endo tooth
15 year recall
4 year recall
CBCT - Lesion size
Resorption on CBCT
Crown root fracture
Lateral luxation
Lateral lesion
PA lesion diagnosis
Large Post