The importance of a bitewing radiograph in the endodontic assessment of posterior teeth

A thorough clinical and radiographic assessment of a posterior tooth is essential prior to embarking on endodontic treatment. This is especially important when the tooth is restored with a large restoration, which is commonly the case. It is important that the restorability of the tooth is assessed. Assessment of the amount and quality of remaining tooth tissue from both direct examination and tactile feedback may be of limited value. Deep recurrent disease will often mean that a posterior tooth is not predictably restorable post endodontic treatment, without crown lengthening.

It is essential that every patient is made fully aware of the long-term challenges facing the restoration of broken down posterior teeth, which require endodontic treatment. This allows them to choose and consent to treatment in a fully informed manner. It also allows a comparative discussion with the dentist of other potential treatment options, including extraction and prosthetic replacement, ie with an implant. Part of this discussion might also involve the comparison of fees and the long term value for money of each option.