Joint Position
Statement of the American Association of Endodontists and the American Academy
of Oral and Maxillofacial Radiology
USE OF CONE-BEAM
COMPUTED TOMOGRAPHY IN ENDODONTICS
INTRODUCTION
The American Association of Endodontists (AAE) and the American
Academy of Oral and Maxillofacial Radiology (AAOMR) have jointly developed this
position statement. It is intended to provide scientifically based guidance to
clinicians regarding the use of cone beam computed tomography (CBCT) in endodontic
treatment as an adjunct to planar imaging. This document will be periodically
revised to reflect new evidence.
Endodontic disease adversely affects quality of life and can
produce significant morbidity in afflicted patients. Radiography is essential
for the successful diagnosis of odontogenic and non-odontogenic pathoses, treatment
of the pulp chamber and canals of a compromised tooth, biomechanical
instrumentation, evaluation of final canal obturation, and assessment of
healing.
Until recently, radiographic assessments in endodontic treatment
have been limited to intraoral and panoramic radiography. These radiographic
technologies provide two-dimensional representations of threedimensional tissues.
If any element of the geometric configuration is compromised, the image can demonstrate
errors1. In more complex cases, radiographic projections with
different beam angulations can allow parallax localization. However, complex
anatomy and surrounding structures can make interpretation of planar “shadows”
difficult.
CONE BEAM COMPUTED
TOMOGRAPHY
The advent of CBCT has made it possible to visualize the
dentition, the maxillofacial skeleton, and the relationship of anatomic
structures in three-dimensions2. Significantly increased use of CBCT
is evidenced by a recent Web-based survey of active AAE members in the U.S. and
Canada which found that 34.2% of 3,844 respondents indicated that they were
utilizing CBCT. The most frequent use of CBCT among the respondents was for
diagnosis of pathosis, preparation for endodontic treatment or endodontic
surgery, and for assistance in the diagnosis of trauma related injuries3.
CBCT, as with any technology, has known limitations.
There are also numerous CBCT equipment manufacturers and models available. In
general, CBCT can be categorized into large, medium, and limited volume units
based on the size of their “field of view.”
