Understanding the anatomy of a tooth before a procedure is even started:  

The success rate for root canal therapy is very high, when a canal system can be thoroughly cleaned and then sealed. The anatomy of teeth can be very complex and challenging, with extra roots, extra canals, dilacerations, and other complexities. Many of these variations cannot be detected with conventional 2D images. Knowing this information certainly is advantageous in an effort to provide a successful outcome. We would all want our surgeon to know as much as possible about our internal anatomy prior to a surgical procedure, to allow for the best possible outcome. Who would not want their endodontist to know as much as possible about our roots and canals before proceeding with a root canal? I assure you there is a very high likelihood if your dentist needed a root canal, the endodontist would want a 3D scan before proceeding, in order to have the best opportunity for a good result.

Concerns related to cracked teeth:

Cracked teeth have always been one of the most difficult dental issues for a patient to deal with. Usually, we have great success saving cracked teeth; but there are other times when patients will have treatments (such as root canals and crowns) and yet the symptoms may not totally alleviate, and extraction might be the eventual outcome. 3D scans can be extremely helpful to learn as much as possible about cracked teeth, so patients can make an informed decision what they would like to do. Some cracks are so tiny that they cannot be seen, even with a CBCT. However, there are other clues which a 3D scan can show, which will help in the diagnosis and understanding of the treatment options. The information attained allows a patient to decide whether to try and save their tooth, or whether they might extract and possibly consider replacement, perhaps with an implant-crown.

Teeth affected by resorption:

Resorption is a process by which the cells which formed our teeth, can become destructive to our tooth structure. It is often times related to trauma, but there are many instances when we do not know why it is occurring (this is called idiopathic resorption). Two-dimensional x-rays might give us a clue that this is occurring, but do not indicate exactly what parts of the tooth are affected, the true extent of the damage and the size and location of the defects. This information can be attained by a 3D scan and is essential in allowing a patient to decide how they would like to handle the issue. Sometimes, a decision might be made to just keep an eye on the tooth;  other times, a decision might be made to to intervene with endodontic treatments, in an effort to arrest the process and save the tooth, for as long as possible.  Unfortunately, sometimes it is determined the resorption problem is so severe that extraction is the best choice; however, this knowledge allows for a treatment plan to be made without the pressure of an emergency situation.

Sinus problems related to infected teeth:

I once had a patient referred to me who had endured two sinus surgeries and was about to have a third, because her symptoms were still persistent. I was able to determine that the problem was actually related to an infected maxillary tooth and the issue was solved with root canal therapy. While two-dimensional x-rays are not helpful at all to visualize the adjacent sinus area, three dimensional scans are extremely helpful in determining if an infected (and often times non-symptomatic) tooth is having an effect on the adjacent sinus membrane.

 Investigating a failing root canal:

If a patient presents with pain or signs of an infection, related to a prior root canal, it is extremely important to try and determine the exact cause and areas of concern. This information is essential in determining what the best treatment options might be and allows for a patient to decide what they feel is the best choice for them. Trying to solve the problem with retreatment is often the most conservative option, but it is important for the endodontist to try and decide if the prospects for success are reasonable, or not. Sometimes a decision might be made that either a surgical approach, or extraction might be the best. The 3D scan helps in the investigation.

Determining when a tooth  might have a hopeless prognosis:

Sometimes a tooth will have a problem which is so bad that the chances of solving it are very small (or maybe even impossible) and extraction might be the best option. Without a 3D scan, sometimes the only way to know for sure is to proceed with initiation of a root canal or exploratory procedure, to see the exact extent of the problem. This can involve an expensive and timely appointment, along with issues related to numbness and possibly discomfort. Patients certainly appreciate when this information can be determined with a 3D scan instead.

Cost of a 3D scan:

The fee we charge for a 3D scan is usually in the area of two or three hundred dollars. This includes the cost of the technology, along with the time - usually an hour or two - to read, process and convey the information. It is always best to try and save a tooth when the outlook looks favorable. However, the cost is certainly substantial - between root canal therapy and a crown, usually a few thousand dollars. This is certainly much less than the typical cost of an implant-crown, which is often in the area of several thousand dollars. It cerainly makes sense to have a 3 D scan prior to starting the treatment plan, to know as much as possible about the situation and also to allow a patient to make an informed decision how they would like to proceed.