What type of x-ray equipment is best for root canal images?

For general practitioners diagnosing the conditions requiring a root canal, x-ray equipment that captures 2D images—particularly equipment capable of producing panoramic x-ray images—is the best and most affordable choice. 2D x-ray images of teeth also allow a dentist or endodontist to see complications that might not be noticed otherwise, especially those present below the gum line or in the jaw such as impacted teeth, abscesses, cysts, tumors, and bone changes linked to some diseases.

Traditionally, dentists used periapical x rays, which show the entire tooth as well as the area beyond the root where the tooth attaches to the jaw, to detect root infections that would require endodontic treatment. Creating a clear periapical x-ray image, however, requires that a high-quality sensor or capture device be placed inside the patient’s mouth.

Panoramic x-ray equipment, on the other hand, produces high-resolution 2D images of the entire tooth without the use of an intraoral sensor or equivalent. Like periapical x-ray images, panoramic x-ray images include the apex or tip of the root of the tooth as well as the area of the surrounding bone tissue. A single panoramic x-ray also offers a full view of the entire mouth—all the teeth in both the upper and lower jaws—and can detect the positions of fully emerged and emerging teeth, the presence of impacted teeth, and the possibility of tumors.

2D x rays vs. 3D dental CBCT for detecting root infection.

Cone beam computed tomography (CBCT) is a special form of dental x-ray technology that provides 3D representations of a patient’s dental structure, nerve paths, bones, and other elements of the teeth and gums. Dental CBCT systems produce high-resolution images with extremely detailed visual information, but the equipment is significantly more expensive than that of 2D x-ray systems.


When comparing 2D and 3D imaging for diagnosis of the root canal system or for assessing the outcome of an endodontic treatment, the x-ray images produced by panoramic x-ray equipment are of similar usefulness. While the amount of detail and insight a high-resolution 3D x-ray image can provide is superior to that of a 2D x-ray image, the additional cost of the CBCT equipment must be considered.  This refers to the cost to the dental practice and the added cost of the imaging to the patient. Based on this cost difference the best choice is the panoramic 2D. That being said, the CBCT system should be considered an adjunct to traditional 2D x-ray equipment with its use reserved for special situations or more complex cases.

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