Impact of Cone-Beam Computed Tomography on the Detection of Missed Canals and Periapical Lesions: A Clinical Perspective

Abstract

Accurate detection of missed canals and periapical lesions remains a major challenge in endodontic diagnosis and retreatment. Conventional two-dimensional radiographs often fail to reveal the complex internal anatomy of teeth due to image distortion and anatomical overlap. The advent of Cone-Beam Computed Tomography (CBCT) has provided a significant advancement by enabling three-dimensional visualization of dental structures, thereby improving diagnostic precision.This study aims to evaluate the clinical impact of CBCT on the detection of missed root canals and periapical lesions, emphasizing its diagnostic superiority over traditional radiographic techniques. A clinical assessment was conducted comparing conventional periapical radiographs and CBCT scans in patients with previously treated teeth presenting with persistent periapical symptoms. Both imaging modalities were analyzed by calibrated endodontists to identify missed canals and periapical pathologies. Statistical comparisons were made to determine the diagnostic differences between the two methods Findings demonstrated that CBCT significantly increased the detection rate of missed canals and periapical lesions compared to conventional radiography. The enhanced diagnostic information obtained from CBCT led to improved treatment planning and more predictable clinical outcomes.:
CBCT serves as an invaluable diagnostic tool in endodontics, allowing for a comprehensive assessment of root canal morphology and periapical pathology. Its application enhances clinical decision-making, particularly in retreatment cases, by minimizing diagnostic uncertainties. While considerations regarding radiation dose and cost remain, the benefits of CBCT in improving endodontic diagnostic accuracy are substantial and clinically relevant.