So often the patient will present with a previous radiograph that was imaged at another. Here presents that intake radiograph that was electronically attached to the patient’s file.

Not a poor image yet it lacked the clarity I would prefer to visualize for the posterior tooth. A decision was made to take a new periapical radiograph and as I often prefer an additional bitewing exposure.

These two radiographs each raised my suspicion as to further dentinal pathology. The periapical view yielded a possible defect in the mesial cervical area, while the bitewing displayed a probable defect towards the distal aspect of the tooth structure. Upon consultation with the patient we made a decision to acquire a CBCT scan of the quadrant.

Here this axial slice displays the loss of sound dentin due to a resorption process. Extensive dentin loss has occurred on the mesial aspect and even more significantly on the distal.

The above displayed coronal slice yields another view of the resorption pattern particularly as it displays the loss of distal tooth structure. Our decision to have this tooth removed was tremendously aided by the visual evidence of our further diagnostic imaging.

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Success in Endodontics 2.0 is an evidence-based online endodontic textbook that shortens the learning curve to do predictable and successful endodontics. This comprehensive, continuing education program was designed for the general dentist who has completed less than 5,000 root canal procedures.

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