(TC66) Intraoperative CBCT Imaging: Streamlining Endodontic Precision

Abstract: It has been well established that integrating CBCT imaging in endodontics significantly enhances our diagnostic abilities and improves clinical decision-making. It offers enhanced recognition of anatomical structures, the presence of pathologic conditions, complex canal systems, and can therefore reduce the risk of iatrogenic damage. Intraoperative CBCT imaging has not been practiced by endodontists and can significantly facilitate our treatment. When used appropriately, it can actually reduce the radiation exposure to the patient by eliminating multiple retakes of intraoperative 2D radiographs. Our novel intraoperative CBCT acquisition approach keeps the rubber dam and clamp in place. The patient's chin is positioned on the CBCT device's chin cup, and using a scout image to confirm field of view (FOV) alignment, we can efficiently obtain scans of the tooth's anatomy and canal system mid-procedure with minimal artifacts. This approach is particularly beneficial in complex cases where traditional imaging fails to provide an unobstructed, detailed visualization of canal anatomy, particularly in areas where root canal preparation with ultrasonics and root canal mapping are needed to guide the clinician during access and instrumentation. This table clinic introduces an advanced intraoperative CBCT technique that significantly contrasts with conventional 2D intraoperative imaging, allowing for superior diagnosis and management of complex root canal systems during endodontic procedures. While 2D radiographs offer limited information due to overlap and distortion of anatomical structures, our 3D CBCT method eliminates these issues, ensuring precise visualization and enhancing clinical decision-making without interrupting the workflow.