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Endodontic treatment characterization

The first step of endodontic therapy is the tooth canal preparation and a proper preparation determines the efficiency of subsequent procedures. One of the main causes of endodontic failure is its inability to completely remove the pulp tissue and microorganisms from the canal system.

Endolab example

By tomographic analysis of tooth before and after treatment it is possible to determine the quality and efficiency of tools and materials used. If the two obtained tomographic structures are not aligned EndoLab allows to achieve a quick image overlapping.

After the superposition, the two structures are merged to highlight the quality of endodontic treatment in 3D. The merged structure allows to assess the instrumentation effect on the canal volume and surface.

The quantitative comparison of pre and post structures allows to estimate the volume of removed dentin, the percentage of treated canal surface for each canal, the volume of debris still present and the distances between the canal surface and the tooth wall.

EndoLab detects portions of the canal where pre and post treatment surfaces are identical and therefore the quality of the treatment is not satisfactory. Pictures on the right show the results of EndoLab analysis, here the problematic zones are marked in red. It can be noted that the effectiveness of treatment diminishes in areas where the canal curvature changes. Detection of untreated surface zones was used to correlate treatment effectiveness with the 3D morphology of the canal.

In order to quantify the volume of removed dentin and the percentage of treated canal surface (PTCS) pre and post treatment canal structures are simultaneously processed. In the presence of canal bifurcations the software allows to choose the canal path to be studied. The output includes a new set of images containing the overlap of the pre and post treatment canal cross section.

The user must select one of the tooth canals, the software simultaneously processes the pre and post structure to determine the profile and therefore the canal surface. Pre and post treatment canal is thus represented in a series of cross-sections. Figure on the left shows four sections of 3 different tooth canals, these pictures are used to quantitatively evaluate where the surface remained unchanged and where the treatment was successful.
All the data organized in tables can be processed by dividing the canal length into three portions (e.g. apical, middle, coronal) or more (e.g. every millimeter). Each portion can be divided into 4 quarters (Mesial, Buccal, Lingual, Distal) or more by choosing an appropriate angular step.