Comments on The Endo Blog: Cone Beam (CBCT): To Use or Not to Use?

Dear Anonymous, I appreciate your comments and po...

2011-09-21T11:13:22.962-07:00

Dear Anonymous,

I appreciate your comments and point of view.

I started this case as a regular root canal without CBCT, under the microscope. I looked extensively for the 2nd distal canal, by opening up the distal canal in a bucco-lingual direction.
Knowing that there was another canal, but not being able to locate it, I decided to take a CBCT. The CBCT showed me the reason I was not finding it, and had to take a much more aggressive lingual approach.
Maybe this is too cliche, but until you have the technology, you really can't appreciate the information it gives you. I would not consider the CBCT as an income source. It usually slows down the consult/treatment & requires more time to interpret. In certain cases, it just gives you more information than you could get otherwise.

I would be glad to discuss this further. Contact me at: info@superendo.com

Dr. Hales, I still wonder who started this case. ...

2011-09-21T06:04:04.800-07:00

Dr. Hales,

I still wonder who started this case. Was it a GP?

Yes, the anatomy was strange; however, initial films should have indicated this before the access was even made.

I just believe in my heart and mind that if this case was referred to an endodontist in the first place, there would have been no need for a CT and likely a perforation would not have occurred.

Without the CT, an endodontist using microscope magnification still would have noticed the perforation and likely would still be able to find the second distal root/canal.

CT is a cool but very expensive tool, and I don't think it was absolutely necessary in a case like this. Just my thoughts...

Dear Anonymous, If you look at the axial slice of...

2011-09-15T13:29:29.660-07:00

Dear Anonymous,

If you look at the axial slice of the CBCT image, you will see that the position of the DL root/canal was in a very odd position. Any experienced clinician with a microscope is less likely to have a perforation, but nevertheless, they can still occur with strange anatomy such as this.

Perhaps a read of the following post: http://www.theendoblog.com/2011/02/cone-beam-computed-tomography-cbct.html will help you understand the limited amount of radiation in this type of imaging (with the J. Morita Veraviewepocs 3de)

Was this case started by an Endodontist who had a ...

2011-09-15T05:34:12.491-07:00

Was this case started by an Endodontist who had a history of using the microscope? If so, I can't imagine this perforation happening or a difficulty in locating the 4th canal. If it wasn't, this patient underwent rather unnecessary radiation exposure (and grief).

Dr. Tismensky, Thanks for your comment. Your blog...

2011-09-12T12:25:44.933-07:00

Dr. Tismensky,

Thanks for your comment. Your blog looks great! I have added you to my list of great dental blogs!

Jason

Dear Caleidor, I don't know where you practic...

2011-09-12T11:56:36.698-07:00

Dear Caleidor,

I don't know where you practice, but if someone offered to do a $600 USD implant around here, it would be in somebody's garage using a wood screw from Home Depot.

2011-09-11T04:24:55.292-07:00
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Nice case Jason! You totally inspired me couple of...

2011-09-10T10:40:22.544-07:00

Nice case Jason! You totally inspired me couple of years ago to start blogging. Initially, I got some ideas from you, and then, got it going. I enjoy reading your posts! Thanks!
I also came acrossed Andreasen's trauma site - www.dentaltraumaguide.org.
It is by far the best trauma reference online.