Dr Paul Moore BDSThe Diagnostic Capabilities of Volume Cat Scan Images.

Endodontic Lesions and Cysts

Gate ClinicDock Road

GalwayIreland091 547592

www.gateclinic.com

Info@gateclinic.com

First volume of a selection of cases

from the 3D Volume scan 2004 - 2012

Please feel free to contact us

The “Volume” scan has been an invaluable aid to our dental practice. In 2004 we introduced the first “I-Cat“ volume scan in europe to our dental practice in Galway Ireland. It has been an invaluable resource, diagnostic aid and treatment planning.In this article I would like to explore some of the range of cases and uses that we have found interesting. On the next page you will find several topics that may be of interest. You may look at one - at several - or choose to watch all.Visualisation facilitates treatment and understanding. The new generation volume cat scans have

revolutionised the dentists ability to diagnose with more accuracy. With the advantage of relatively low radiation compared to conventional cat scans ( from 6 - 35 times less radiation than full scale hospital cat scans), and distortion free images, the clinician can investigate the underlying hard tissues, airway spaces and their relationship to vital structures such as the inferior nerve bundle in the mandible ( lower jaw).

Endodontic Lesions and CystsDiagnosis and Treatment Planning

Three dimensional assessment allows for a diferent point of view both for the clinician and the patient. Understanding of the problem and discussion of the concerns, the observations and the options.Improved diagnosis and treatment planning with more complete informed consent can be acheived with an enhanced understanding and prognosis.

This scan was to investigate the options for implant placement in the upper arch revealed an assymptomatic patholgy on the 35.

35 sagittal coronal and axial views of the peripaical pathology.

The “locator” device pinpoints the same point in all three planes automatically.The orientation of the patholgy, the extent and the proximity to neighbouring structures may be assessed.

Endodontics Case 1

Images from “Co-diagnostics” software on following page for implant planning .Sinus grafting was also required.

The unrestored 35 was root treated prior to implant placement in the 36 region. Failure to identify this may have lead to failure of the implant and potential litigation.

Lower right molar root treated tooth was non symptomatic.

The molar was fractured coronally.

No periapical pathology visible or pdl enlargement.

The third, fourth and fifth images shows no obturation in the disto-

lingual canal.

Endodontics Case 2

Lower right molar root treated tooth was non symptomatic. The molar was fractured coronally.No periapical pathology visible or pdl enlargement.

Endodontics Case 2

37 sagittal coronal and axial views of the peripaical pathology, allowing identification and quantification of which root is failing. In this case the disto-buccal and mesiobuccal appear to merge, The disto-buccal canal is not obturated. The mesiobuccal root obturation is short of the apex.

Endodontics Case 3

Trauma from Sport Injury 10 years previousThis scan was taken to investigate the extent of a periapical cyst. To help formulate the correct treatment plan option.The 22 presented asympomatic but with a small amount of mobility.

Endodontics Case 4

The patient’s only concern was the colour - the tooth was dark.Full dimensional analysis from salient points can be measured and recorded. Note the wide canal in the lateral incisor.

First image is a periapical radiograph.The cortical bone hides the full extent of the lesion within the medullary bone.The second image is the axial image of the lateral incisor.The third image shows the palatal perforation of the cyst

Endodontics Case 5

This scan was taken for implant planning and these pathologies were discovered incidentally.

These periapical infections were not visible on periapical x rays.

Endodontics Case 6

Axial Saggital

and CoronalViews.

Three dimensional views identify,

locate, and

quantify the cystic pathology to facilitate treatment

planning.

UR3 Non Symptomatic cyst Compare to periapical.

Endodontics Case 5

Patient presented

with discomfort in the

sulcus UL5 .

Barely visible on the

peripical and

mimicing the lower

border of the floor of

the sinus, the

following cat scan

show a well defined

pathology.

This was treated with

apicectomy.

Endodontics Case 5

Lower un-erupted wisdom tooth.The cyst around the crown and the root of the tooth was undetected.

The remaining teeth were to be extracted and the scan taken to assess the roots that we knew

Endodontics Case 8

Buccal three dimensional view showing perforation

Cross sectional view.

Occlusal view showing perforation also

Lingual assessment