dentist in the background holding up a side mouth xray to the foreground

CBCT is revolutionizing the approach to endodontic care but knowing how to identify and differentiate anatomical variations from typical endodontic presentation is critical to ensure ideal patient outcomes.

In the new “Not Every Tooth With a Radiolucent Lesion Needs a Root Canal” Spear Study Club module, endodontist Dr. David Landwehr discusses different interpretation strategies for various imaging techniques. He explains the diagnostic limitations of pulp testing and discusses how the subjective interpretation of radiographs and CBCT imaging can lead to diagnostic misinterpretations or mistakes.

Landwehr, an endodontist from Madison, Wisconsin, is dual trained in oral and maxillofacial pathology. This is his first video presentation for a Spear Study Club module.

“Radiographic assessments in endodontic treatment provide two-dimensional representations of three-dimensional anatomic structures. If any element of the geometric configuration is compromised, the image may demonstrate error,” Landwehr said.

“Many radiolucencies are asymptomatic and discovered on routine radiographs but knowing how to identify and differentiate them from the typical endodontic presentation is critical to ensure ideal management and outcome,” he added. “Club members who can accurately interpret radiolucencies from various imaging techniques will gain more predictable outcomes and fewer diagnostic mistakes.”

By showing this module, study club leaders can demonstrate to club members how they're committed to more comprehensive interdisciplinary treatment planning.

The success of nonsurgical root canal therapy depends on the identification of canals, cleaning, shaping and obturation of root canal systems, as well as the quality of the final restoration.

START A VIRTUAL CLUB: Has the public health crisis kept you from networking in person with your referring practices? Discover how Spear Study Club provides virtual tools and online resources to help your specialist practice with recovery.

Study Club members go beyond periapical cysts and granulomas in this module and discover what it takes to accurately interpret radiolucencies that yield a differential diagnosis that could result in earlier treatment and a potentially better prognosis.

The new module leaves Study Club members more confident in their ability to:

  • Employ different interpretation strategies for various imaging techniques.
  • Recognize that radiographs alone won't make a definitive pulpal and periapical diagnosis.
  • Express how developmental, metabolic and neoplastic etiologies can closely resemble an inflammatory cause.
  • Recognize that a radiographic lesion, not pupal in origin, warrants further evaluation for accurate diagnosis.