Launch of the endodontics book by Prof. Ricardo Machado with our own chapter: Radiology Applied to Endodontics.
Since the beginning of endodontics, certain discoveries were decisive for its evolution, from a simple empirical act of pain removal to the treatments we have today. A decisive milestone, if not the most important, was the discovery of x-rays and their consequent use in dentistry and endodontic treatment. Radiology, therefore, brought endodontics to the level of science as we know it today.
The radiographic examination is the resource that allows the clinician to plan and observe the various stages of his work, as well as the final evaluation and communication between colleagues and patients. It also enables rapid assessment of the dental tissues, root canal anatomy, adjacent bone tissues, as well as determining the length of the endodontic work and the fit of the obturation cone, and the final and subsequent evaluation of the treatment.
History
Only 4 years after the discovery of X-rays by William Röntgen and the first dental radiograph by Otto Walkhoff, in 1895, Edmund Kells took the first radiograph for endodontic purposes, after introducing a metal wire into a root canal of a central incisor. He also described radiolucent radiographic images, characteristic of periapice lesions. Weston Price, in 1901, had already observed the characteristic radiographic image of incomplete obturation, advocating for the first time the use of radiography to verify the quality of endodontic obturation 2.
Limitations of the radiographic examination
Despite its wide use in endodontics, radiography has some limitations. This fact serves as a constant warning for the clinician in the interpretation of images.
Radiography is a two-dimensional examination used for the observation of bodies that have three dimensions. This fact has to be constantly taken into consideration by the observer, since the interpretation of such images has to take into account the superimpositions of different anatomical structures on the areas of interest. Furthermore, it is not possible to correctly estimate the dimensions and shape of the images in the buccal/lingual direction. 3, 4. Another aspect concerns the purpose of the exam, which is used only as an aid in diagnosis, depending on other complementary exams and mainly on the case history and clinical examination. Moreover, the radiographic exam allows different interpretations by observers, and even by the same observer at different times.
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