What is the Importance of X-rays During Root Canal Treatment?

Dental x-rays are the advanced diagnostic aids that enable the dentist to visualize the areas of the mouth that are covered by the oral tissues. Moreover, dentists rely on the x-rays to accurately diagnose different dental diseases and plan appropriate treatment. One of the conventional treatments that require intensive use of dental x-rays is root canal treatment. Root canal treatment is a dental procedure which deals with the removal of the infected pulp tissues. Additionally, it cleans the root canals and fills them with appropriate tooth filling material.

Usually, dental x-rays are required at every step of the procedure. Pre-operative radiographs are used to determine the type and extent of tooth infection. Operative x-rays are used to measure the working length and progress of the treatment.

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Post-operative dental x-rays are taken to check the healing process of root canal therapy. Several types of dental x-rays aid in root canal treatment, such as periapical radiographs, panoramic, and bitewings. Today’s article will highlight the importance of dental x-rays during the root canal procedure. Moreover, we will look at the types of dental x-rays used during the root canal procedure.

What is the importance of dental x-rays during root canal treatment?

Dental x-rays are typically used to help the dentist to diagnose and evaluate the need for root canal treatment accurately. It mainly assists the dentist to visualize the tooth, its root, and the surrounding structures that are often hidden under the gum and jaw bone. (1)

The visualization of all these structures enables the dentist to identify the signs of infection, the location of the disease, and its extension into the supporting tissues. Additionally, dental x-rays are also used during the root canal procedure to check the progress of tooth cleaning and proper placement of the filling material.

What are the types of dental x-rays required for root canal procedure?

There is a wide range of dental x-rays useful for the dentist to plan for root canal treatment. Some of the commonly used dental x-rays during root canal procedure are listed below –

Bitewing x-rays

Bitewings are a special type of radiographs that are capture three to four teeth from both the dental arches in one frame. Usually, the tooth crown and half of the tooth root is exposed to bitewings. In this process, the x-ray film is placed in a holder. The patient is asked to bite on the holder that positions the x-ray beam parallel to the tooth. (2)

Bitewings are typically used to examine the bone surrounding the tooth and also to visualize the root canal openings.

Periapical radiograph

Periapical radiographs are used to examine the path of the root canal and the condition of the surrounding bone. Usually, in this process, the x-ray film is placed close to the concerned tooth. On exposure, the film captures the tooth from its crown to the tip of the root. (3)

Panoramic x-ray

Panoramic x-rays provide a full view of all the teeth and bone of the mouth. They are used by endodontists to identify problems with other teeth in the mouth that may need a root canal treatment.

CBCT

Cone-beam computed tomography provides a 3D view of the soft tissue, bone, teeth, and the surrounding nerves in a single scan. It aids in better diagnosis and to evaluate the true extent of the disease, which cannot be interpreted clearly with traditional periapical radiographs.

When are dental x-rays taken during the root canal procedure?

Typically, radiographs are used in three different stages of the root canal treatment –

Pre-operative radiographs

Before the procedure, the dentist takes dental x-rays to diagnose the dental condition and determine the need for root canal treatment. A panoramic and periapical radiograph often suffice during this step of the procedure. (4)

Once the process is about to start, the dentist can use the periapical radiographs to record the working length of the root canal. Moreover, the dentist can verify the tooth anatomy before drilling the tooth.

Operative radiographs

During the root canal procedure, the working length is confirmed by taking a periapical radiograph with the file inside the root canal of the tooth. Other x-rays are made during the cleaning process to check the progress of the treatment.

A third radiograph is taken with the master file in the root canal of the tooth. This is to determine proper tapering and length of the root canal. A final radiograph is taken before obturation to check the extent and fit of the master cone in the prepared root canal. (5)

Post-operative radiographs

Post-operative radiographs are usually taken to check the healing of the tooth and to assess appropriate treatments. Recall radiographs are taken periodically to determine the success of the root canal treatment.

Take away message

Dental x-rays are a necessary and indispensable diagnostic tool that is required for several dental procedures. It aids the dentist to visualize the tooth and supportive structures that are often hidden under the gums and jaw bone.

Radiographs are used at every step of the root canal treatment. Pre-operative radiographs are used to diagnose the condition. Moreover, they help determine the working length of the root canal and veru=ifying the tooth anatomy.

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Operative radiographs are used to check the progress of the cleaning process and to determine the fit od the master file and master cone, respectively. Post-operative radiographs are used to follow up and to determine the success of the root canal treatment.

Typically a series of panoramic, periapical and bitewing x-rays are used. The dentist carefully interprets the radiographs and proceeds with the treatment.

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