EVALUATION OF CONE-BEAM COMPUTED TOMOGRAPHY FOR DIAGNOSIS: ACCURATE DETECTION AND DIAGNOSIS: NARRATIVE REVIEW

Abstract

Understanding root canal morphology is crucial for successful endodontic treatment. Accessory canals, isthmuses, documented curvatures, bifurcations, and even early apical pathologies that are found in posterior teeth, are some of the complex anatomical features found in such teeth which are difficult to appreciate in planar radiography. Such features are often missed in the periapical and panoramic radiographs, resulting in incomplete debridement, persisting infection, and treatment failure. With the advent of CBCT, diagnostic imaging has been revolutionized because it allows detailing of tooth structures from multiple angles in 3D, as well as offering high-resolution imaging and minimal distortion, thus CBCT enhances acuity of diagnosis and optimizes treatment planning. This review evaluates CBCT's posterior tooth imaging focuses on the diagnosis of additional canals, assessing root curvatures, diagnosing vertical root fractures, evaluating root resorptive defects, and characterizing periapical lesions. When evaluating the diagnostic accuracy and utility of conventional radiography and CBCT, it is clear that the performance of conventional radiography is rather suboptimal. However, factors such as CBCT's costs, limited availability, the necessity of specialized training, and radiation exposure must be taken into account. Important endodontic organizations have advocated CBCT as an additional imaging method, but it should not be used as a substitute to the standard images which have to be done in every case. CBCT is recommended for complex cases, cases with uncertain diagnosis, cases with treatment challenges, and cases with complication-prone treatment. Provided that evidence-based guidelines and ALARA are respected, the diagnostic precision of endodontic treatment greatly improves, refining the treatment plan and boosting the overall patient outcome.