The Use of Cone-beam Computed Tomography (CBCT) for Orientation of Root Canals: A Case Report of Acute Apical Periodontitis

Abstract

 Purpose: The use of cone-beam computed tomography (CBCT) in the diagnosis of complex endodontic cases has been well documented in recent literatures. In this case report, we present a successful case of treatment of acute apical periodontitis by CBCT for detecting the root canals.
 Case Description: The patient was a 79-year-old male manifesting strong spontaneous pain and occlusal pain in the upper left premolars. From the clinical finding and dental X-ray images, we diagnosed the first premolar as flare-up of a chronic apical abscess with partial pulp necrosis, and the second premolar as acute apical periodontitis. Although we tried drainage via root canals to ease the acute pain, it was difficult to access root canals because of the thickly formed dentin made of secondary and tertiary dentin. Sectional images obtained by CBCT enabled us to remove thickly formed dentin safely and to access the root canals, thus leading to successful treatment of infected root canals.
 Conclusion: CBCT scanning was extremely effective for the detection of root canals covered by thickly formed dentin.