Diagnostic value of computed tomography in re-treatment of root fillings in maxillary molars.
OBJECTIVE
To compare the diagnostic information and radiation dose between intraoral radiography and computed tomography (CT) in re-treatment decision making concerning root fillings in maxillary molars.


METHODS
Thirty-nine root-filled maxillary molars with suspected apical periodontitis were examined with two intraoral periapical radiographs and CT. Presence of periapical lesion/s per tooth and root were analysed for both techniques. In addition, in the CT images, the number of root canals, erosion, or perforation of cortical bone plates, and the distance between palatal root and cortical bone plates were evaluated. Radiation dose for CT was registered and calculated; and that of periapical radiographs used as reported previously (Ekestubbe et al. 2004).


RESULTS
Periapical radiographs revealed periapical lesions in 33 teeth compared with 38 on CT images. A lesion of any root was detected more often with CT. The mesiobuccal root had two root canals in 30 teeth of which 27 of the MB2 canals were not filled, and 22 roots with an unfilled canal were associated a periapical lesion. Distances to palatal root, from the buccal and palatal cortex were measured in CT and varied between 5.0-12.0 mm and 0-4.0 mm, respectively. Based on the radiographic information, a variety of treatment alternatives were suggested. Mean effective dose of periapical radiographs was 0.02 mSv and that of CT 0.055 mSv.


CONCLUSIONS
Computed tomography may give important information in re-treatment decision when considering root fillings in maxillary molars. The radiation dose should be considered individually.
Huumonen
S
S
Department of Oral and Maxillofacial Radiology at the Sahlgrenska Academy, Göteborg University/Public Dental Health Service, Göteborg, Sweden.
Kvist
T
T
Gröndahl
K
K
Molander
A
A
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003657:Decision Making; D005260:Female; D006801:Humans; D008297:Male; D008437:Maxilla; D008875:Middle Aged; D008963:Molar / Q000000981:diagnostic imaging*; D010485:Periapical Periodontitis / Q000000981:diagnostic imaging*; D011829:Radiation Dosage; D011861:Radiography, Dental / Q000379:methods*; D019233:Retreatment; D012390:Root Canal Therapy; D014057:Tomography, X-Ray Computed / Q000379:methods; D014092:Tooth Root / Q000000981:diagnostic imaging*