The aim of this case report is to present two cases where cone beam computed tomography (CBCT) was used for the diagnosis, treatment planning, and followup of large periapical lesions in relation to maxillary anterior teeth treated by endodontic surgery. Periapical disease may be detected sooner using CBCT, and their true size, extent, nature, and position can be assessed. It allows clinician to select the most relevant views of the area of interest resulting in improved detection of periapical lesions. CBCT scan may provide a better, more accurate, and faster method to differentially diagnose a solid (granuloma) from a fluid-filled lesion or cavity (cyst). In the present case report, endodontic treatment was performed for both the cases followed by endodontic surgery. Biopsy was done to establish the confirmatory histopathological diagnosis of the periapical lesions. Long-term assessment of the periapical healing following surgery was done in all the three dimensions using CBCT and was found to be more accurate than IOPA radiography. It was concluded that CBCT was a useful modality in making the diagnosis and treatment plan and assessing the outcome of endodontic surgery for large periapical lesions.

It is generally agreed that the successful treatment of a badly broken tooth with pulpal disease depends not only on good endodontic therapy, but also on good prosthetic reconstruction of the tooth after the endodontic therapy is complete. Often, we come across an endodontically treated tooth with little or no clinical crown in routine clinical cases. In such cases, additional retention and support of the restoration are difficult to achieve. Two case reports are discussed here where structurally compromised, endodontically treated, posterior teeth were restored using the Richmond crown in the first case, and by the use of two nonparallel cast posts in the second case.

The need for evaluating the structures in three dimensions led to the revolutionary invention of cone beam computed tomography (CBCT). CBCT had found its application in various regions of dentistry. The literature demonstrates the use of CBCT for specifi c endodontic applications. The purpose of this article is to review the history and evolution of CBCT, its advantages over conventional radiography and to discuss the literature validating its application in endodontics.

Aim: 1] Comparative evaluation of the linear depth of induced remineralized lesions after subjecting to fluoride supplements and 2] To assess the average fluorescence at both the demineralized and the remineralized zones in all the three study groups under confocal laser scanning microscope. Method: Forty five sound human premolars extracted for orthodontic reasons were decoronated 1 mm below the cemento-enamel junction and coated with nail varnish except for a 3 × 3 mm window on the buccal surface. The samples were placed in 50 ml of de mineralizing solution at pH 4.6 for 96 hours. Following demineralization, the lower half of the 3 × 3 mm window in all the samples were covered with nail varnish to serve as control. The samples were randomly divided into three groups of fifteen teeth each (n = 15) and specimens in group A[Nfd] were remineralized using non-fluoridated dentifrice [control], those in groups B [Fd5] and group C [Fd10] using 500 ppm and 1000 ppm of fluoride containing dentifrice, respectively. The specimens were subjected to a 20 day remineralization treatment regimen and were sectioned into 100 µm thick sections and two images were captured on the buccal surface from either side of the midpoint of occluso-cervical length using confocal laser scanning microscope [CLSM]. Results: were tabulated and statistically analyzed by Anova. Study concluded that 1000 ppm fluoridated dentifrice showed a greater degree of remineralization than other groups and confocal laser scanning microscopes gives promising results in the diagnosis of early enamel lesions over the conventional methods.

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Management of a tooth with open apex is a challenge to the dental practitioners. Evaluation of the periapical healing is required in such cases by radiographic techniques. The objective of this paper was to assess the healing of a periapical lesion in a non-vital tooth with open apex treated with mineral trioxide aggregate (MTA) obturation using cone beam computed tomography (CBCT). The endodontic treatment of a fractured non-vital discolored maxillary left lateral incisor with an open apex was done with MTA obturation. The clinical and radiographic followup done regularly showed that the tooth was clinically asymptomatic and that the size of the periapical lesion observed by intraoral periapical (IOPA) radiographs and CBCT was decreased remarkably after two years. CBCT and IOPA radiographs were found to be useful radiographic tools to assess the healing of a large periapical lesion in a non-vital tooth with open apex managed by MTA obturation.

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