Ming-Gene Tu
Treating calcified canals presents a significant challenge in endodontics due to the difficulty in locating and negotiating the canals, the increased risk of instrument separation, and the potential for inadequate cleaning and shaping. Radiographic imaging plays a crucial role in the diagnosis, assessment, and treatment planning of these complex cases. Periapical radiographs offer initial insights into the presence and extent of canal calcification. However, cone-beam computed tomography (CBCT) provides a more detailed, three-dimensional evaluation of the root canal anatomy. Unlike conventional periapical radiography, CBCT eliminates superimposition of surrounding structures, offering clinically relevant information through axial, sagittal, and coronal slices. CBCT imaging significantly enhances diagnostic accuracy and guides more effective treatment strategies, particularly in complex cases such as calcified canals, retreatment procedures, and internal or external root resorption. In this presentation, we will share a series of successfully managed cases involving these conditions, where the use of CBCT imaging contributed to improved outcomes. The detailed anatomical information obtained through CBCT led to more precise treatment planning and more predictable clinical results. While CBCT may not be necessary for every root canal treatment, it is increasingly considered a valuable tool and potentially the standard of care for managing challenging endodontic cases.