**4.7 Recommendations**

*Oral Diseases*

allows shaping, cleaning and filling.

CBCT over conventional radiology [41]. (**Figure 6**).

carried out to determine the diagnostic capacity of CBCT in these cases. Successful endodontic treatment depends on the correct identification of all root canals; this

Non-identification of the anatomy is one of the main causes of endodontic failure. Matherne et al. in 2008 compared the ability of three board-certified endodontists to detect the number of root canals on intraoral digital radiographs and CBCT images on 72 teeth extracted in 3 equal groups of upper molars, lower premolars and mandibular incisors. The observers could not detect at least one of the root canals in 40% of the teeth using 2D images, which demonstrate the advantage of

**172**

**Figure 8.**

**Figure 7.**

*Patient with second untreated palatine canal.*

*Upper premolar with presence of taurodontism.*

Following the consensus documents prepared by the American Association of Endodontics and the European Society of Endodontics, some recommendations are established for the use of CBCT in endodontics. The first recommendation states that intraoral radiography should be the choice for endodontic treatment, while a small field CBCT would be recommended for those patients with confused or nonspecific signs with untreated teeth or with previous endodontic treatments (**Figure 7**). They also recommend that CBCT could be considered for those teeth that are more likely to have complex anatomies or accessory root canals, (**Figure 8**) also if a CBCT has not been taken before, it could be considered to locate calcified root canals. However, for postoperative follow-up, the treatment of choice should be intraoral radiography. When the possibility of a vertical fracture is suspected if the need for CBCT can be considered, the same as when an injury does not heal and we have to consider the possibility of periapical surgery and when we find perforations or separate instruments before carry out a retreat; it is also recommended when we need to assess the proximity of delicate anatomical areas as well as for the management of dento-alveolar trauma in the absence of soft tissue damage or maxillofacial involvement [42, 43].
