CBCT - Pain and periapical abscess tooth #14 - CBCT assists in locating canals during root canal!

Another case for you, this is a patient from last night actually. He presented at about 5 p.m. with a really intense pain on his upper left. So this is 14 right here and 15 there. He was pretty confident it was 14 and it did turn out to be 14. Previous endo on 15, it looked like it was fine. There's a little bit of thickening in this PDL space, but when you compare this to the x-ray from last time, this is an improvement. It's a fairly recent root canal. Not one done here in this office, but it looks like it was done well as you evaluate it. So CVCT of course highlights and clarifies and demonstrates exactly what's going on in this case. You can see the widening of the PDL space there on that mesial buccal root. Same thing here, that same area. I'm widening the PDL space and then look at all this thickening of the mucosal tissue in the sinus. He wasn't aware of any sinus issues, but this area up in the sinus adjacent to tooth number 14 was a dramatic thickening, widening there. So I started the root canal and then I could not find that distal buccal canal. Couldn't find it. So I went back to the CVCT and pulled up the axial slice. Let me zoom in here a little bit and once I was able to scroll through here a little bit and determine there was not a mesial buccal 2 canal, after determining there was no MB2 and determining that I was a little too mesial for the distal buccal canal, we got in there. So three canals there ended up a real nice outcome. The completion was real simple since I knew where the canal was. So I was tropping around in this area, got kind of close, I took a step back and evaluated with a CVCT and determined exactly where that MB, I'm sorry, the distal buccal canal was. The palatal and the mesial buccal were easy to find. There was no MB2, although it looks like there might be a little ghost of one. I could not find one and I'm not seeing anything really clearly in this x-ray. So distal buccal was found and obturated thanks to CVCT technology. What a great blessing!