This chapter describes the indications and value of periapical, bitewing, panoramic, and cone beam computed tomography (CBCT) in the diagnostic process. The selection of appropriate radiographs is described in the context of ALARA (as low as reasonably achievable) in terms of radiation exposure. The importance of using more than one radiograph for diagnosis is stressed.
The biology and selection of appropriate sensibility and other clinical tests is critical to the diagnostic process. The importance of using more than one test is emphasized. Diagnostic complications are also reviewed. All sensibility tests are subject to false-positive (i.e., a positive response from a necrotic pulp) and false-negative responses (i.e., a negative response from a vital pulp).
In order to establish a diagnosis and treatment plan, the clinician must synthesize the results of radiographs, sensibility tests, and other clinical findings. No single radiograph or sensibility test is ever sufficient. Information drawn from additional radiographs or sensibility tests may be invaluable in reaching a diagnosis and treatment plan. The importance of periodontal probing is emphasized. Periodontal probing may provide important information that is not observed on radiographs or visual examination.
