Main indications for the use of Cone Beam computadorized tomography in Endodontics
DOI:
https://doi.org/10.33448/rsd-v14i6.48971Keywords:
Tomography, Endodontics, Cone-beam.Abstract
Introduction: One of the basic principles of endodontics is the disinfection of root canals, for which proper instrumentation and clear visualization of the preparation are essential. Radiography is indispensable in this process; however, it has limitations due to its two-dimensional visualization of a three-dimensional object. Objective: The aim of this literature review is to examine the main applications of cone beam computed tomography (CBCT) in Endodontics and to provide an overview that enables the dental surgeon to assess its necessity in diagnosis and endodontic treatment planning. Materials and Methods: The research was conducted through electronic searches in the Scielo, Revista ABRO, PubMed, and Google Scholar databases. A total of 62 sources were selected based on the following criteria: publications between 1988 and 2024, full-text articles, and books that, in their content, address topics related to the use of computed tomography in Endodontics. Conclusion: The development of cone beam computed tomography has gained increasing importance in dentistry and endodontics, especially in cases where conventional radiographs do not provide adequate image quality or are insufficient, thereby compromising the clinician’s confidence in decision-making and intervention.
Downloads
References
Almeida, A. P. R. et al. (2012). Localização radiográfica pelo método de Clark: princípios e indicações. Sci Invest Dent. 1 (1), 4.
Andreasen, F. M. & Kahler, B. (2015). Pulpal response after acute dental injury in the permanent dentition: clinical implications – a review. Journal of Endodontics. 4 (3), 299–308.
Bueno, M. R. et al. (2018). Development of a new Cone-beam computed tomography software for endodontic diagnosis. Brazilian Dental Journal. 29(6), 517–29.
Cavalcanti, M. (2010). Tomografia computadorizada por feixe cônico. Editora Santos.
Casarin, S. T. et al. (2020). Tipos de revisão de literatura: considerações das editoras do Journal of Nursing and Health. Journal of Nursing and Health. 10(5). https://periodicos.ufpel.edu.br/index.php/enfermagem/article/view/19924.
Cevidanes, L. H., Styner, M. A. & Proffit, W. R. (2006). Image analysis and superimposition of 3-dimensional cone-beam computed tomography models. American Journal of Orthodontics and Dentofacial Orthopedics. 129(5), 611–8.
Chen, Y. et al. (2023). Artificial intelligence in endodontics: deep learning detection of periapical lesions in CBCT images. Journal of Endodontics. 49(2), 123–30.
Chiarreli, P. & Brow, W. J. (1999). Leaking urine in Australian women: prevalence and associated conditions. Women Health. 29(1): 1-13. doi: 10.1300/J013v29n01_01.
Cleghorn, B. M., Christie, W. H. & Dong, C. C. (2006). Root and root canal morphology of the human permanent maxillary first molar: a literature review. Journal of Endodontics. 32(9), 813–21.
Cotton, T. P. et al. (2007). Endodontic applications of cone beam volumetric tomography. Journal of Endodontics. 33(9), 1121–32.
Dalili Kajan, Z. et al. (2018). Accuracy of Cone-beam Computed Tomography in Comparison with Standard Method in Evaluating Root Canal Morphology: An In Vitro Study. Iranian Endodontic Journal. 13(2), 181–7.
Estévez, R. et al. (2010). Invasive cervical resorption class III in a maxillary central incisor: diagnosis and follow-up by means of cone-beam computed tomography. Journal of Endodontics. 36(12), 2012–4.
Estrela, C. et al. (2008). A new periapical index based on cone beam computed tomography. Journal of Endodontics. 34(11), 1325–31.
Estrela, C. et al. (2008). Accuracy of cone beam computed tomography and panoramic and periapical radiography for detection of apical periodontitis. Journal of Endodontics. 34(3), 273–9.
Estrela, C. et al. (2015). Frequency of root canal isthmuses in human permanent teeth determined by cone-beam computed tomography. Journal of Endodontics. 41(9), 1535–9.
Estrela, C. et al. (2008). Method for determination of root curvature radius using cone-beam computed tomography images. Brazilian Dental Journal. 19(2), 114–8.
Estrela, C. et al. (2009). Method to evaluate inflammatory root resorption by using cone beam computed tomography. Journal of Endodontics. 35(11), 1491–7.
European Commission. (2023). Radiation Protection 195: Guidelines on the Implementation of ALADAIP in Dental Imaging. Directorate-General for Energy, Radiation Protection Series.
Gao, Y. et al. (2006). C-shaped canal system in mandibular second molars part IV: 3-D morphological analysis and transverse measurement. Journal of Endodontics. 32(11), 1062–65.
Garib, D. G. et al. (2007). Tomografia computadorizada de feixe cônico (cone beam): entendendo este novo método de diagnóstico por imagem com promissora aplicabilidade na ortodontia. Revista Dental Press de Ortodontia e Ortopedia Facial. 12(2), 139–56.
Gil, A. C. (2017). Como elaborar projetos de pesquisa. 6ed. Atlas. González-Martín, M. et al. (2023). CBCT vs periapical radiographs for diagnosing endodontic pathologies: a systematic review. Clinical Oral Investigations. 27, 309–18.
Gröndahl, H. G. & Huumonen, S. (2004). Radiographic manifestations of periapical inflammatory lesions: how new radiological techniques may improve endodontic diagnosis and treatment planning. Endodontic Topics. 8(1), 55–67.
Gu, L. et al. (2009). A microcomputed tomographic study of canal isthmuses in the mesial root of mandibular first molars in a Chinese population. Journal of Endodontics. 3 (3), 353–6.
Hassan, B. et al. (2009). Detection of vertical root fractures in endodontically treated teeth by a cone beam computed tomography scan. Journal of Endodontics. 35(5), 719–22.
He, B. Z. et al. (2007). Clinical evaluation of different angulation radiograph in diagnosing multiple canals of mandibular first premolars in vivo.
Hua Xi Kou Qiang Yi Xue Za Zhi. 25 (2), 156–8. He, W. et al. (2020). Endodontic treatment of maxillary first molars presenting with unusual asymmetric palatal root morphology using spiral computerized tomography: a case report. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology and Endodontology. 109(1), e55–e59.
Huang, X. et al. (2024). Performance of AI-based models in detecting root resorptions and vertical fractures using cone-beam CT. International Endodontic Journal. 57(1), 45–52.
Huumonen, S. et al. (2006). Diagnostic value of computed tomography in re-treatment of root fillings in maxillary molars. International Endodontic Journal. 39(10), 827–33.
Kamburoglu, K. et al. (2009). Measurements of mandibular canal region obtained by cone-beam computed tomography: a cadaveric study. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology and Endodontology. 107(2), e34–42.
Khojastepour, L. et al. (2015). Assessment of root perforation within simulated internal resorption cavities using cone-beam computed tomography. Journal of Endodontics. 4 (9), 1520–3.
Kourkouta, S. & Bailey, G. C. (2014). Periradicular regenerative surgery in a maxillary central incisor: 7-year results including cone-beam computed tomography. Journal of Endodontics. 40(7), 1013–19.
Kurt, S. N. et al. (2014). Outcomes of periradicular surgery of maxillary first molars using a vestibular approach: a prospective, clinical study with one year of follow-up. Journal of Oral and Maxillofacial Surgery. 72(6), 1049–61.
Lascala, C. A., Panella, J. & Marques, M. M. (2004). Analysis of the accuracy of linear measurements obtained by cone beam computed tomography (CBCT–NewTom). Dentomaxillofacial Radiology. 33(5), 291–4.
Lim, G. et al. (2014). Endodontic and surgical treatment of root damage caused by orthodontic miniscrew placement. Journal of Endodontics. 39(8), 1073–7.
Lofthag-Hansen, S. et al. (2007). Limited cone-beam CT and intraoral radiography for the diagnosis of periapical pathology. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology and Endodontology. 103(1), 114–9.
Low, K. M. et al. (2008). Comparison of periapical radiography and limited cone-beam tomography in posterior maxillary teeth referred for apical surgery. Journal of Endodontics. 34(5), 557–62.
Ludlow, J. B. et al. (2007). Accuracy of measurements of mandibular anatomy in cone beam computed tomography images. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology and Endodontology. 103(4), 534–42.
Maini, A., Durning, P. & Drage, N. (2008). Resorption: within or without? The benefit of cone-beam computed tomography when diagnosing a case of an internal/external resorption defect. British Dental Journal. 204(3), 135–7.
Mattuella, L. G. et al. (2005). Root canals and apical foramina of the buccal root of maxillary first premolars with longitudinal sulcus. Brazilian Dental Journal. 16(1), 23–9.
Moraes, S. H., Aragão, E. M. & Heck, A. R. (1998). Radiologia em endodontia. In: Berger, C. R. (Org.). Endodontia. São Paulo: Pancast. cap. 11, p. 183–92.
Nair, M. K. & Nair, U. P. (2007). Digital and advanced imaging in endodontics: a review. Journal of Endodontics. 33(1), 1–6.
Nakagawa, Y. et al. (2002). Preoperative application of limited cone beam computerized tomography as an assessment tool before minor oral surgery. International Journal of Oral and Maxillofacial Surgery. 31(3), 322–6.
Nakata, K. et al. (2006). Effectiveness of dental computed tomography in diagnostic imaging of periradicular lesion of each root of a multirooted tooth: a case report. Journal of Endodontics. 32(6), 583–7.
Nakata, K. et al. (2009). Evaluation of correspondence of dental computed tomography imaging to anatomic observation of external root resorption. Journal of Endodontics. 35(11), 1594–7.
Orhan, K., Aksoy, U. & Kalender, A. (2010). Cone-beam computed tomographic evaluation of spontaneously healed root fracture. Journal of Endodontics. 36(9), 1584–7. doi: 10.1016/j.joen.2010.04.004.
Pablo, Ó. V. et al. (2010). Root anatomy and canal configuration of the permanent mandibular first molar: a systematic review. Journal of Endodontics. 36(12), 1919–31.
Patel, S. et al. (2009). New dimensions in endodontic imaging: part 1. Conventional and alternative radiographic systems. International Endodontic Journal. 42(6), 447–62.
Patel, S. et al. (2007). The potential applications of cone beam computed tomography in the management of endodontic problems. International Endodontic Journal. 40, 818–30.
Patel, S. (2009). New dimensions in endodontic imaging: part 2. Cone-beam computed tomography. International Endodontic Journal. 42, 463–75.
Pereira A. S. et al. (2018). Metodologia da pesquisa científica. [free e-book]. Editora UAB/NTE/UFSM.
Pinsk, H. M., Champleboux, G. & Sarment, D. P. (2007). Periapical surgery using CAD/CAM guidance: preclinical results. Journal of Endodontics. 33(2), 148–51.
Pinsky, H. M. et al. (2006). Accuracy of three-dimensional measurements using cone-beam CT. Dentomaxillofacial Radiology. 35 (6), 410–6.
Reddy, Y. P., Karpagavinayagam, K. & Subbarao, C. V. (2008). Management of dens invaginatus diagnosed by spiral computed tomography: a case report. Journal of Endodontics. 34(9), 1138–42.
Rosa, J. E. & Tavares. D. (1988). Método de Clark. In: Métodos radiográficos especiais para o cirurgião dentista. Editora EPUME. cap. 2, p. 3–24.
Rother, E. T. (2007). Revisão sistemática x revisão narrativa. Acta Paul. Enferm. 20(2). https://doi.org/10.1590/S0103-21002007000200001.
Saletta, D. et al. (2005). Root curvature: differences among dental morphotypes and modifications after mechanical instrumentation. Journal of Periodontology. 76(5), 723–30.
Shemesh, H. et al. (2011). The use of cone-beam computed tomography and digital periapical radiographs to diagnose root perforations. Journal of Endodontics. 37(4), 513–6.
Simon, J. H. et al. (2006). Differential diagnosis of large periapical lesions using cone-beam computed tomography measurements and biopsy. Journal of Endodontics. 32(9), 833–7.
Singh, A. et al. (2024). Cone beam computed tomography in endodontics: current evidence and future perspectives. Journal of Dental Research. 103(3), 240–52.
Siqueira, J. F. & Rôças, I. N. (2008). Clinical implications and microbiology of bacterial persistence after treatment procedures. Journal of Endodontics. 34(11), 1291–301.
Soares, M. G. et al. (2007). Tomografia convencional, computadorizada e computadorizada volumétrica com tecnologia cone beam. Espelho Clínico. 9, 7–12.
Stavropoulos, A. & Wenzel, A. (2007). Accuracy of cone beam dental CT, intraoral digital and conventional film radiography for the detection of periapical lesions. Clinical Oral Investigations. 11(1), 101–6.
Terakado, M. et al. (2007). Diagnostic imaging with newly developed ortho cubic super-high resolution computed tomography (Ortho-CT). Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology and Endodontology. 89, 509–11.
Tomar, D. et al. (2013). Endodontic management of mandibular third molar with three mesial roots using spiral computed tomography scan as a diagnostic aid: a case report. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology. 115(5): e6-10. doi: 10.1016/j.oooo.2011.10.032.
Tsurumachi, T. & Honda, K. (2007). A new cone-beam computerized tomography system for use in endodontic surgery. International Endodontic Journal. 40, 224–32.
Von Strechow, D. et al. (2003). Three-dimensional quantitation of periradicular bone destruction by microcomputed tomography. Journal of Endodontics. 29(4), 252–6.
Weine, F. S. (1998). Cálculo do comprimento de trabalho. In: Tratamento endodôntico. Editora Santos. p.395–422.
Weissman, J. et al. (2015). Association between the presence of apical periodontitis and clinical symptoms in endodontic patients using cone-beam computed tomography and periapical radiographs. Journal of Endodontics. 44(11), 1824–9.
White, S. C. & Mallya, S. M. (2012). Update on the biological effects of ionizing radiation, relative dose factors and radiation hygiene. Australian Dental Journal. 57(1), 2–8.
Zhao, J. et al. (2011). Three-dimensional computed topography analysis of a patient with an unusual anatomy of the maxillary second and third molars. International Journal of Oral Sciences. 3(4), 225–8. 12)
Downloads
Published
Issue
Section
License
Copyright (c) 2025 Julia de Morais Teodoro; Thais Cristina Xavier de Assis; Robson da Silva Loesch; Olegário Antônio Teixeira Neto; Leonardo Araújo de Andrade; Claudio Maranhão Pereira

This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
1) Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
2) Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
3) Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.