Two Dimensional Versus Three Dimensional Imaging in Endodontics - An Updated Review

Abstract

BACKGROUNDRadiographic imaging is a preliminary and essential step in the diagnosis, treatment planning and followup of all the cases in endodontics. The interpretation of an image can be influenced by several confounding factors including the regional anatomy a nd superimposition of both teeth and the surrounding dentoalveolar structures. Due to the complexity of the maxillofacial skeleton, conventional two dimensional (2-D) radiographic images fail to provide accurate information of the particular region of interest. Superimposition of the images, seen in planar periapical radiography, reveal only limited information about a three dimensional (3-D) object. The structures so visualised are also subject to geometric distortion. Hence, recent research has highlighted the need for 3-D imaging modality to overcome the potential drawbacks of conventional radiography. Medical Computed tomography (CT) was one of the earliest three dimensional imaging systems. It has been used in the field of endodontics over the past decade but with limited success. This can be ascribed to high radiation exposure, lengthy scan time and cost factor. The next new phase in imaging modalities came with the advent of cone beam computed tomography (CBCT). Contemporary endodontics emphasise on the significance of CBCT, since it limits the radiation exposure and rapidly provides 3D reconstructed images which have been proven to be accurate in all aspects. This paper reviews the importance of three dimensional CBCT technology over conventional two dimensional imaging system along with its potential drawbacks. BACKGROUND Diagnostic imaging is considered as an important adjunct in clinical assessment of the patient. Since time immemorial, radiology has played a critical role in dentistry and now with expanding array of different imaging modalities, it has become an indispensable tool in endodontic assessment as well. The first intraoral radiograph to be used in dentistry was reported by Sir C Edmond Kells. 1 Thereafter, field of radiology has seen several changes. With improvements in the film technology and reduced exposure times, gradually film based system gave way to advanced sensor based digital systems. Solid state sensors like charge coupled device (CCD), complementary metal oxide semiconductor (CMOS) and photostimulable phosphor plates (PSP) largely replaced the film based conventional imaging. 2, 3, 4 Digital systems also provided opportunities for image processing and modification (colour, brightness, contrast) which further assisted the diagnostic process. But the images were still a two dimensional representation of three dimensional anatomy and the need for cross sectional information was still unmet.

A Quantitative Assessment to Compare the Dimensions of the Alveolar Ridge Width Using Different Techniques for Implant Placement

“…Schwarz and other researchers introduced cone beam computerized tomography (CBCT) as an auxiliary test in pre-surgical planning for dental implant treatment. The role of CBCT in providing accurate linear measurements of height and width and three-dimensional (3D) evaluation of the alveolar ridge with the fabrication of surgical guides is also useful during the placement of implants [ 7 ].…”