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The Essential Dental Tool: CT Scan

Laura Wittenauer, DDSWhen patients come to us with vague symptoms, it makes the etiology for their pain difficult to locate.  Working with an endodontist using cone beam technology can be very beneficial to your diagnosis of these patients’ pain.

Identifying the Pain
Friend, in the Journal of Endodontics, indicated that only 37% of patients can accurately determine the source of their odontogenic pain.  Referred pain is very common due to convergence of the pain producing neurons to the same second order terminals in the nucleus caudalis. This convergence can make it very frustrating for both us and the patient when no positive identification of the offending tooth is isolated.

Radiograph Limitations
Seltzer and Bender in 1961 determined that lesions of endodontic origin must perforate or significantly thin the buccal cortical plate to be visible on the radiograph.  And when the infection is contained solely in the cancellous bone, the lesion is not visible on the radiograph.

CT Scan Advantages
Lo in the endodontic literature proved that the CT scan shows more periapical pathology than 2-D radiographs. In most instances, a periapical x-ray can show small changes in the bone, but the CT images can show a lesion of significant size and provide you with the exact source of the problem.  This trait makes the CT scan a great tool.

The CT scan is also very helpful in dental retreatment cases in determining if a tooth is restorable.  The scan can show root fractures, bone loss and missed canals.

Overall, the CT allows your endodontist to be more thorough in their diagnosis which leads to enhanced diagnostics and ultimately providing the best treatment for your patients. If your endodontist is not using cone beam technology, encourage them to investigate the benefits in the dental treatment of your patients.

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Dr. Laura Wittenauer has her private practice in Newport Beach, California. A native of western Kansas, Dr. Laura attended Kansas State University where she received a Bachelor of Science degree in Pre-Dentistry. She then attended the University of Missouri-Kansas City School of Dentistry. After graduating she initially established her practice in Lawrence, Kansas for eighteen years. Dr. Laura and her family relocated to southern California to allow her husband to attend the University of Southern California School of Dentistry and complete a residency program in Endodontics. Dr. Laura’s practice focuses on helping patients achieve optimum oral health. The most rewarding aspect of her practice is taking care of special needs patients. She is active in many professional and civic organizations including the American Academy of Cosmetic Dentistry, California Dental Association of which she is a member of Board of Managers, Orange County Dental Society. She especially enjoys helping dentists learn at the Dawson Academy in St. Petersburg, Florida. She is a member of Pi Beta Phi sorority and served as Alumni Advisory Chairman. She also serves as a eucharistic minister and lector for her church. Dr. Laura and her husband of twenty-six years, Rick, have two children. They enjoy participating in activities with their children, attending USC sporting events, running and golf.