CASE STUDY: A 42 year old female was referred to DMDI for a Cone Beam CT of the 21/22 region. The referrer expressed concerns regarding potential horizontal root fracture of 21 and coronal root fracture of 22, due to recent trauma.

A CBCT using a dedicated device (J.Morita A170) was performed, using a 4 x 4 cm field of view in order to produce a high resolution (80μm) scan of the region.

conebeam-diagram-1

Fig 1. Cross-section slices of 21 (a) and 22 (b), and 3D images of 21 (c) and 21 & 22 AP (d): DMDI J. Morita 3D Accuitomo 170 CBCT

CBCT report by Dr Charles Lott MBBS (Adel.) FRCR FRANZCR: 21: There is an oblique undisplaced fracture extending from the anterior root surface at the junction of the proximal and mid thirds extending distally and posteroinferiorly through the root canal to the posterior surface at the junction of the mid and distal thirds of the root. The buccal bone plate is thin but not fractured. (Fig. 1a, 1c, 1d, 2a, 2c).

22: Oblique fracture commencing at the palatal alveolar ridge margin and extending anteroinferiorly into the pulp chamber and Cone Beam CT confirms position and extent of traumatic root fractures across to the opaque repair. Intact buccal bone plate. (Fig. 1b, 2b, 2d).

Fig 2. Axial (a & b), and coronal (c & d) slice images: DMDI J. Morita 3D Accuitomo 170 CBCT

Fig 2. Axial (a & b), and coronal (c & d) slice images: DMDI J. Morita 3D Accuitomo 170 CBCT

The appearance of the adjacent dentition (11, 12, 23, 24) were all reported as normal.

Clearly identifying and understanding the extent and exact positions and angles of root fractures is crucial for the prognosis of the affected dentition. Two-dimensional imaging is often insufficient to discern such information. In this case the clear demonstration of the fracture margins, including the root canal and bone plate involvement, establishes confidence in diagnosis and treatment planning. This is just one valuable application of high-resolution CBCT imaging in endodontic cases.

DMDI provides unique, high quality CBCT scans and reconstructions with quick imaging and report turnarounds to help deliver optimal patient outcomes and enhance treatment planning.

 

 

 

 

 

 

Contact: Dental & Medical Diagnostic Imaging
9/1175 Toorak Rd, Camberwell Vic 3124. Tel: 03 9889 1771
Web: dmdi.com.au

admag913