A Clinician’s Guide to Clinical Endodontics
Current Radiographic Examination Including Periapical, Bitewings, and/or CBCT

Uraba et al reported that cone-beam computed tomography (CBCT) imaging is effective at detecting approximately 20% more periapical lesions than are periapical radiographs, particularly in the maxillary anterior and posterior teeth.⁸

When a patient presents for restorative treatment and reports that a tooth is asymptomatic, a dentist may assume that the pulpal and periradicular diagnosis is within normal limits and hence may skip the above objective clinical tests, with the possible exception of taking a radiograph. However, using only a dental radiograph to determine the etiology of tooth pain and the pretreatment pulpal and periradicular status may lead to a pulpal and periradicular misdiagnosis (Figure 3). Therefore, a clinician must perform all five objective tests to obtain an accurate pretreatment pulpal and periradicular diagnosis.