Endodontik Radyoloji
Özet
Bu bölüm, endodontik tanı ve tedavide kullanılan temel görüntüleme yöntemlerini kapsamlı biçimde incelemektedir. İntraoral periapikal radyografi, yüksek çözünürlüğü ve düşük radyasyon dozu sayesinde endodontik değerlendirmede ilk tercih edilen yöntemdir; kök kanal morfolojisi, periapikal patolojiler ve tedavi sonrası kontrollerde kritik rol oynar. Panoramik radyografi ise geniş görüntü alanı ile başlangıç taramalarında avantaj sağlar ancak süperpozisyon ve distorsiyon nedeniyle lezyon düzeyi incelemelerde mutlaka periapikal radyografiyle desteklenmelidir. Literatür, panoramik radyografinin apikal periodontitis tespitinde düşük duyarlılığa sahip olduğunu göstermektedir. Konik ışınlı bilgisayarlı tomografi (KIBT), üç boyutlu hacimsel bilgi sunarak karmaşık anatomilerin, rezorpsiyonların, vertikal kırıkların ve tedavi başarısızlıklarının değerlendirilmesinde tanısal doğruluğu belirgin biçimde artırır. Radyasyon dozunun daha yüksek olması nedeniyle yalnızca gerekli klinik durumlarda ve küçük FOV kullanılarak tercih edilmelidir. Bölümde ayrıca klinik kullanımda yer almayan ancak araştırmalarda altın standart kabul edilen mikro-BT de ele alınmaktadır. Mikro-BT, çok yüksek çözünürlüklü voksel yapısı sayesinde kök kanal anatomisini, isthmus ve aksesuar kanalları, dentin kalınlığını ve tedavi kalite analizlerini ayrıntılı biçimde ortaya koyar.
This section reviews the main imaging methods used in endodontic diagnosis and treatment. Intraoral periapical radiography is the first-choice tool due to its high resolution and low radiation, essential for evaluating root canal morphology, periapical lesions, and post-treatment follow-ups. Panoramic radiography offers a wide field of view for initial screening but has limitations due to distortion and superimposition, requiring periapical radiographs for detailed lesion assessment. Studies show panoramic imaging has low sensitivity for detecting apical periodontitis. Cone-beam computed tomography (CBCT) provides three-dimensional volumetric data, improving diagnostic accuracy in complex anatomies, resorptions, vertical fractures, and treatment failures; its use should be limited to necessary cases with a small field of view due to higher radiation. Micro-CT, though not used clinically, is the research gold standard, offering extremely high-resolution voxel data for detailed analysis of root canal anatomy, isthmuses, accessory canals, dentin thickness, and treatment quality.
Referanslar
Whaites E, Drage N. Essentials of Dental Radiography and Radiology E-Book: Essentials of Dental Radiography and Radiology E-Book: Elsevier Health Sciences; 2020.
Sarsam W, Davies J, Al-Salehi SK. The role of imaging in endodontics. British Dental Journal. 2025;238(7):448-57.
Antony DP, Thomas T, Nivedhitha M. Two-dimensional periapical, panoramic radiography versus three-dimensional cone-beam computed tomography in the detection of periapical lesion after endodontic treatment: A systematic review. Cureus. 2020;12(4).
Benavides E, Krecioch JR, Connolly RT, Allareddy T, Buchanan A, Spelic D, et al. Optimizing radiation safety in dentistry: clinical recommendations and regulatory considerations. The Journal of the American Dental Association. 2024;155(4):280-93. e4.
Wajer R, Dabrowski-Tumanski P, Wajer A, Kazimierczak N, Serafin Z, Kazimierczak W. Enhancing Image Quality in Dental-Maxillofacial CBCT: The Impact of Iterative Reconstruction and AI on Noise Reduction—A Systematic Review. Journal of Clinical Medicine. 2025;14(12):4214.
Yeung AWK, Wong NSM. Reject rates of radiographic images in dentomaxillofacial radiology: a literature review. International Journal of Environmental Research and Public Health. 2021;18(15):8076.
Mallya S, Lam E. White and Pharoah's oral radiology: principles and interpretation: Elsevier Health Sciences; 2018.
Stera G, Giusti M, Magnini A, Calistri L, Izzetti R, Nardi C. Diagnostic accuracy of periapical radiography and panoramic radiography in the detection of apical periodontitis: a systematic review and meta-analysis. La radiologia medica. 2024;129(11):1682-95.
Gupta A, Devi P, Srivastava R, Jyoti B. Intra oral periapical radiography-basics yet intrigue: A review. Bangladesh Journal of Dental Research & Education. 2014;4(2):83-7.
Kim Y, Lee S, Jo G, Kwon A, Kang J, Kim J, et al. Comparative analysis of clinical image evaluation charts for panoramic radiography. Oral Radiology. 2024;40(4):520-9.
Kweon HH-I, Lee J-H, Youk T-m, Lee B-A, Kim Y-T. Panoramic radiography can be an effective diagnostic tool adjunctive to oral examinations in the national health checkup program. Journal of periodontal & implant science. 2018;48(5):317-25.
Mupparapu M, Akintoye SO. Application of panoramic radiography in the detection of osteopenia and osteoporosis—Current state of the art. Current Osteoporosis Reports. 2023;21(4):354-9.
Gandhi JM, Govindaraju L. Evaluation of requirement of taking panoramic radiographs in children less than 6 years of age-A retrospective study. Journal of Family Medicine and Primary Care. 2022;11(5):2146-9.
Rushton V, Horner K, Worthington H. Routine panoramic radiography of new adult patients in general dental practice: relevance of diagnostic yield to treatment and identification of radiographic selection criteria. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology. 2002;93(4):488-95.
Lingam AS, Koppolu P, Abdulsalam R, Reddy RL, Anwarullah A, Koppolu D. Assessment of common errors and subjective quality of digital panoramic radiographs in dental institution, Riyadh. Annals of African Medicine. 2023;22(1):49-54.
MacDonald D, Stojkova BJ, Reitzik S. Positioning and preparation errors impacting dental panoramic radiographs in patients with mixed dentition. Imaging Science in Dentistry. 2024;54(4):336.
Anbiaee N, Pahlavanzadeh P. Evaluation of Panoramic Radiography Diagnostic Accuracy in the Assessment of Interdental Alveolar Bone Loss Using CBCT. Clinical and Experimental Dental Research. 2024;10(6):e70042.
Berghuis G, Cosyn J, De Bruyn H, Hommez G, Dierens M, Christiaens V. A controlled study on the diagnostic accuracy of panoramic and peri-apical radiography for detecting furcation involvement. BMC Oral Health. 2021;21(1):115.
Turosz N, Chęcińska K, Chęciński M, Sielski M, Sikora M. Evaluation of dental panoramic radiographs by artificial intelligence compared to human reference: a diagnostic accuracy study. Journal of Clinical Medicine. 2024;13(22):6859.
Mureșanu S, Hedeșiu M, Iacob L, Eftimie R, Olariu E, Dinu C, et al. Automating dental condition detection on panoramic radiographs: challenges, pitfalls, and opportunities. Diagnostics. 2024;14(20):2336.
Kazimierczak W, Wajer R, Wajer A, Kalka K, Kazimierczak N, Serafin Z. Evaluating the diagnostic accuracy of an AI-driven platform for assessing endodontic treatment outcomes using panoramic radiographs: a preliminary study. Journal of Clinical Medicine. 2024;13(12):3401.
Hennig C-L, Schüler IM, Scherbaum R, Buschek R, Scheithauer M, Jacobs C, et al. Frequency of dental X-ray diagnostics in children and adolescents: what is the radiation exposure? Diagnostics. 2023;13(3):394.
Alshomrani F. Cone-beam computed tomography (CBCT)-based diagnosis of dental bone defects. Diagnostics. 2024;14(13):1404.
Distefano S, Cannarozzo MG, Spagnuolo G, Bucci MB, Lo Giudice R. The “dedicated” CBCT in dentistry. International Journal of Environmental Research and Public Health. 2023;20(11):5954.
Bromberg N, Brizuela M. Dental Cone Beam Computed Tomography. StatPearls. Treasure Island (FL)2025.
Suomalainen A, Pakbaznejad Esmaeili E, Robinson S. Dentomaxillofacial imaging with panoramic views and cone beam CT. Insights into imaging. 2015;6(1):1-16.
Tsuji T, Yoshida S, Hommyo M, Oyama A, Kumagai S, Shiraishi K, et al. Cone beam computed tomography image-quality improvement using “one-shot” super-resolution. Journal of Imaging Informatics in Medicine. 2025;38(4):2120-33.
Polizzi A, Serra S, Leonardi R. Use of CBCT in orthodontics: A scoping review. Journal of Clinical Medicine. 2024;13(22):6941.
Dogan Y, Sirin Y. Assessing oral surgery residents’ competencies and training needs in tomography interfaces through a usability framework. BMC Medical Education. 2025;25(1):1058.
Kim N-H, Yang B-E, Kang S-H, Kim Y-H, Na J-Y, Kim J-E, et al. Preclinical and Preliminary Evaluation of Perceived Image Quality of AI-Processed Low-Dose CBCT Analysis of a Single Tooth. Bioengineering. 2024;11(6):576.
Abesi F, Maleki M, Zamani M. Diagnostic performance of artificial intelligence using cone-beam computed tomography imaging of the oral and maxillofacial region: A scoping review and meta-analysis. Imaging Science in Dentistry. 2023;53(2):101.
Pinto JC, de Faria Vasconcelos K, Leite AF, Wanderley VA, Pauwels R, Oliveira ML, et al. Image quality for visualization of cracks and fine endodontic structures using 10 CBCT devices with various scanning protocols and artefact conditions. Scientific reports. 2023;13(1):4001.
Ozdede M, Akay G, Karadag Atas O, Koc EK, Yalcin O, Gungor K. Repeatability and effect of different voxel sizes on linear and volumetric tooth and pulp measurements using cone-beam computed tomography. BMC oral health. 2024;24(1):1472.
Soltani P, Devlin H, Etemadi Sh M, Rengo C, Spagnuolo G, Baghaei K. Do metal artifact reduction algorithms influence the detection of implant-related injuries to the inferior alveolar canal in CBCT images? BMC Oral Health. 2024;24(1):268.
Jo G-D, Park C-W, Jeon KJ, Han S-S. Quantitative evaluation of metal artifact reduction in CBCT under varying exposure modes and rod orientations. Scientific Reports. 2025;15(1):20645.
Kazimierczak W, Kazimierczak N, Issa J, Wajer R, Wajer A, Kalka S, et al. Endodontic treatment outcomes in cone beam computed tomography Images—Assessment of the diagnostic accuracy of AI. Journal of Clinical Medicine. 2024;13(14):4116.
Kolarkodi SH. The importance of cone-beam computed tomography in endodontic therapy: A review. The Saudi Dental Journal. 2023;35(7):780-4.
Ren S, Wang W, Cheng M, Tang W, Zhao Y, Miao L. Guided endodontics in the application of personalized mini-invasive treatment in clinical cases: a literature review. The Saudi Dental Journal. 2025;37(4):20.
Pai S, Edwards D, Taylor G. How effective is CBCT-guided endodontic access over ‘brain-guided’accesses, and is this a likely addition to the general dental practitioner’s armamentarium? Evidence-Based Dentistry. 2025;26(1):8-9.
Lavanya A, Ali S, Tewari RK. Micro-computed tomography in endodontics. Journal of Oral Research and Review. 2023;15(1):80-6.
Karobari MI, Batul R, Khan M, Patil SR, Basheer SN, Rezallah NNF, et al. Micro computed tomography (Micro-CT) characterization of root and root canal morphology of mandibular first premolars: a systematic review and meta-analysis. BMC Oral Health. 2024;24(1):1.
Hristov K, Gigova R, Gateva N, Angelova L. Micro-computed tomography (micro-CT) evaluation of root canal morphology in immature maxillary third molars. Journal of Clinical Pediatric Dentistry. 2024;48(3).
Agwan MAS, editor Micro-Computed Tomography as a Transformative Tool in Endodontics: A Narrative Review. Medical Forum Monthly; 2023.
Referanslar
Whaites E, Drage N. Essentials of Dental Radiography and Radiology E-Book: Essentials of Dental Radiography and Radiology E-Book: Elsevier Health Sciences; 2020.
Sarsam W, Davies J, Al-Salehi SK. The role of imaging in endodontics. British Dental Journal. 2025;238(7):448-57.
Antony DP, Thomas T, Nivedhitha M. Two-dimensional periapical, panoramic radiography versus three-dimensional cone-beam computed tomography in the detection of periapical lesion after endodontic treatment: A systematic review. Cureus. 2020;12(4).
Benavides E, Krecioch JR, Connolly RT, Allareddy T, Buchanan A, Spelic D, et al. Optimizing radiation safety in dentistry: clinical recommendations and regulatory considerations. The Journal of the American Dental Association. 2024;155(4):280-93. e4.
Wajer R, Dabrowski-Tumanski P, Wajer A, Kazimierczak N, Serafin Z, Kazimierczak W. Enhancing Image Quality in Dental-Maxillofacial CBCT: The Impact of Iterative Reconstruction and AI on Noise Reduction—A Systematic Review. Journal of Clinical Medicine. 2025;14(12):4214.
Yeung AWK, Wong NSM. Reject rates of radiographic images in dentomaxillofacial radiology: a literature review. International Journal of Environmental Research and Public Health. 2021;18(15):8076.
Mallya S, Lam E. White and Pharoah's oral radiology: principles and interpretation: Elsevier Health Sciences; 2018.
Stera G, Giusti M, Magnini A, Calistri L, Izzetti R, Nardi C. Diagnostic accuracy of periapical radiography and panoramic radiography in the detection of apical periodontitis: a systematic review and meta-analysis. La radiologia medica. 2024;129(11):1682-95.
Gupta A, Devi P, Srivastava R, Jyoti B. Intra oral periapical radiography-basics yet intrigue: A review. Bangladesh Journal of Dental Research & Education. 2014;4(2):83-7.
Kim Y, Lee S, Jo G, Kwon A, Kang J, Kim J, et al. Comparative analysis of clinical image evaluation charts for panoramic radiography. Oral Radiology. 2024;40(4):520-9.
Kweon HH-I, Lee J-H, Youk T-m, Lee B-A, Kim Y-T. Panoramic radiography can be an effective diagnostic tool adjunctive to oral examinations in the national health checkup program. Journal of periodontal & implant science. 2018;48(5):317-25.
Mupparapu M, Akintoye SO. Application of panoramic radiography in the detection of osteopenia and osteoporosis—Current state of the art. Current Osteoporosis Reports. 2023;21(4):354-9.
Gandhi JM, Govindaraju L. Evaluation of requirement of taking panoramic radiographs in children less than 6 years of age-A retrospective study. Journal of Family Medicine and Primary Care. 2022;11(5):2146-9.
Rushton V, Horner K, Worthington H. Routine panoramic radiography of new adult patients in general dental practice: relevance of diagnostic yield to treatment and identification of radiographic selection criteria. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology. 2002;93(4):488-95.
Lingam AS, Koppolu P, Abdulsalam R, Reddy RL, Anwarullah A, Koppolu D. Assessment of common errors and subjective quality of digital panoramic radiographs in dental institution, Riyadh. Annals of African Medicine. 2023;22(1):49-54.
MacDonald D, Stojkova BJ, Reitzik S. Positioning and preparation errors impacting dental panoramic radiographs in patients with mixed dentition. Imaging Science in Dentistry. 2024;54(4):336.
Anbiaee N, Pahlavanzadeh P. Evaluation of Panoramic Radiography Diagnostic Accuracy in the Assessment of Interdental Alveolar Bone Loss Using CBCT. Clinical and Experimental Dental Research. 2024;10(6):e70042.
Berghuis G, Cosyn J, De Bruyn H, Hommez G, Dierens M, Christiaens V. A controlled study on the diagnostic accuracy of panoramic and peri-apical radiography for detecting furcation involvement. BMC Oral Health. 2021;21(1):115.
Turosz N, Chęcińska K, Chęciński M, Sielski M, Sikora M. Evaluation of dental panoramic radiographs by artificial intelligence compared to human reference: a diagnostic accuracy study. Journal of Clinical Medicine. 2024;13(22):6859.
Mureșanu S, Hedeșiu M, Iacob L, Eftimie R, Olariu E, Dinu C, et al. Automating dental condition detection on panoramic radiographs: challenges, pitfalls, and opportunities. Diagnostics. 2024;14(20):2336.
Kazimierczak W, Wajer R, Wajer A, Kalka K, Kazimierczak N, Serafin Z. Evaluating the diagnostic accuracy of an AI-driven platform for assessing endodontic treatment outcomes using panoramic radiographs: a preliminary study. Journal of Clinical Medicine. 2024;13(12):3401.
Hennig C-L, Schüler IM, Scherbaum R, Buschek R, Scheithauer M, Jacobs C, et al. Frequency of dental X-ray diagnostics in children and adolescents: what is the radiation exposure? Diagnostics. 2023;13(3):394.
Alshomrani F. Cone-beam computed tomography (CBCT)-based diagnosis of dental bone defects. Diagnostics. 2024;14(13):1404.
Distefano S, Cannarozzo MG, Spagnuolo G, Bucci MB, Lo Giudice R. The “dedicated” CBCT in dentistry. International Journal of Environmental Research and Public Health. 2023;20(11):5954.
Bromberg N, Brizuela M. Dental Cone Beam Computed Tomography. StatPearls. Treasure Island (FL)2025.
Suomalainen A, Pakbaznejad Esmaeili E, Robinson S. Dentomaxillofacial imaging with panoramic views and cone beam CT. Insights into imaging. 2015;6(1):1-16.
Tsuji T, Yoshida S, Hommyo M, Oyama A, Kumagai S, Shiraishi K, et al. Cone beam computed tomography image-quality improvement using “one-shot” super-resolution. Journal of Imaging Informatics in Medicine. 2025;38(4):2120-33.
Polizzi A, Serra S, Leonardi R. Use of CBCT in orthodontics: A scoping review. Journal of Clinical Medicine. 2024;13(22):6941.
Dogan Y, Sirin Y. Assessing oral surgery residents’ competencies and training needs in tomography interfaces through a usability framework. BMC Medical Education. 2025;25(1):1058.
Kim N-H, Yang B-E, Kang S-H, Kim Y-H, Na J-Y, Kim J-E, et al. Preclinical and Preliminary Evaluation of Perceived Image Quality of AI-Processed Low-Dose CBCT Analysis of a Single Tooth. Bioengineering. 2024;11(6):576.
Abesi F, Maleki M, Zamani M. Diagnostic performance of artificial intelligence using cone-beam computed tomography imaging of the oral and maxillofacial region: A scoping review and meta-analysis. Imaging Science in Dentistry. 2023;53(2):101.
Pinto JC, de Faria Vasconcelos K, Leite AF, Wanderley VA, Pauwels R, Oliveira ML, et al. Image quality for visualization of cracks and fine endodontic structures using 10 CBCT devices with various scanning protocols and artefact conditions. Scientific reports. 2023;13(1):4001.
Ozdede M, Akay G, Karadag Atas O, Koc EK, Yalcin O, Gungor K. Repeatability and effect of different voxel sizes on linear and volumetric tooth and pulp measurements using cone-beam computed tomography. BMC oral health. 2024;24(1):1472.
Soltani P, Devlin H, Etemadi Sh M, Rengo C, Spagnuolo G, Baghaei K. Do metal artifact reduction algorithms influence the detection of implant-related injuries to the inferior alveolar canal in CBCT images? BMC Oral Health. 2024;24(1):268.
Jo G-D, Park C-W, Jeon KJ, Han S-S. Quantitative evaluation of metal artifact reduction in CBCT under varying exposure modes and rod orientations. Scientific Reports. 2025;15(1):20645.
Kazimierczak W, Kazimierczak N, Issa J, Wajer R, Wajer A, Kalka S, et al. Endodontic treatment outcomes in cone beam computed tomography Images—Assessment of the diagnostic accuracy of AI. Journal of Clinical Medicine. 2024;13(14):4116.
Kolarkodi SH. The importance of cone-beam computed tomography in endodontic therapy: A review. The Saudi Dental Journal. 2023;35(7):780-4.
Ren S, Wang W, Cheng M, Tang W, Zhao Y, Miao L. Guided endodontics in the application of personalized mini-invasive treatment in clinical cases: a literature review. The Saudi Dental Journal. 2025;37(4):20.
Pai S, Edwards D, Taylor G. How effective is CBCT-guided endodontic access over ‘brain-guided’accesses, and is this a likely addition to the general dental practitioner’s armamentarium? Evidence-Based Dentistry. 2025;26(1):8-9.
Lavanya A, Ali S, Tewari RK. Micro-computed tomography in endodontics. Journal of Oral Research and Review. 2023;15(1):80-6.
Karobari MI, Batul R, Khan M, Patil SR, Basheer SN, Rezallah NNF, et al. Micro computed tomography (Micro-CT) characterization of root and root canal morphology of mandibular first premolars: a systematic review and meta-analysis. BMC Oral Health. 2024;24(1):1.
Hristov K, Gigova R, Gateva N, Angelova L. Micro-computed tomography (micro-CT) evaluation of root canal morphology in immature maxillary third molars. Journal of Clinical Pediatric Dentistry. 2024;48(3).
Agwan MAS, editor Micro-Computed Tomography as a Transformative Tool in Endodontics: A Narrative Review. Medical Forum Monthly; 2023.
