Is it necessary for an endodontist to have the capability of taking panoramic radiographs and/or CBCT images? This would be a good example of why it is useful for an endodontist to have digitial imaging capable of a panoramic and CBCT imaging. This is a 29 yo healthy female was referred to our office for evaluation and treatment of #18 or #19. Clinical exam and radiographic survey revealed non-leaking amalgam restorations associated with both #18 and #19. Pulp vitality testing was WNL for both teeth tested as well as control teeth. It was noted that appeared to be pericoronitis associated with the horizontally impacted 3rd molar (#17). We were able to probe in the area and case significant bleeding due to the extent of inflamed tissue. Because we were unable to visualize the full extent of the 3rd molar with conventional periapical radiographs, we decided to start with a panoramic radiograph (shown above). Low and behold, we noted a previously unidentified radiolucency associated with the tooth (red arrows). Although we could have taken a CBCT, we have deferred that imaging modality to the oral surgeon while managing this lesion and likely with biopsy. Root canal therapy was not indicated on either teeth #18 or #19. As clinicians, we don’t always have to know exactly what something is. However, it is our responsibility to recognize NORMAL vs ABNORMAL.

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