Abstract
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.
Key Words
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Article info
Publication history
Published online: September 16, 2010
Identification
Copyright
© 2011 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.
