Download The apical periodontitis diagnosis takes great importance in

The apical periodontitis diagnosis takes great importance in adoption of an
efficient therapy in control of endodontic infection and evaluation of the
treatment success. However, 2D X-ray images can not be effective to visualize
these bone loss, requiring 30 to 50% of demineralization to be viewable
therethrough. Some studies have verified, by their results, that Cone Beam
Computed Tomography (CBCT) promotes more accurate detection of periapical
bone resorption. The purpose of this case report is to demonstrate by two
cases, that the use of conventional periapical radiographs for detection of apical
periodontitis should be performed with caution in uncertain cases because of
the possibility of obtaining a false negative diagnose, while the cone beam
computed tomography images can get greater accuracy in these situations.
Clinical Case 1: A periapical radiograph of the tooth 23, of a male patient, was
sent in order to evaluate the possibility of treating a root perforation. A CBCT
scan in Prexion 3D Elite scanner was requested to better evaluate the
periradicular damages. Surprisingly, a large bone resorption could be seen
through all tomographic reconstructions demonstrating much more complexity
than expected and the case was referred to maxillofacial surgeon. Clinical Case
2: female patient was referred by an orthodontist for evaluation of tooth 22,
which had been submitted about three years ago to a parendodontic surgery.
The professional requested authorization to make orthodontic movement in this
tooth. Likewise, a CBCT Prexion Elite 3D scan was required, since the
conventional periapical radiography had not elucidated so good the case. The
tomographic images showed a large area not regenarated in all directions and
the orthodontist was advised to wait for the complete periradicular repair.
Conclusion: The CBCT images must be used in doubtful cases to detect
periapical bone resorption.