Abstract
Background and Aim: This narrative review aimed to evaluate the applications of micro-computed tomography (µCT) in endodontic research, with emphasis on its contributions to the understanding of root canal morphology, assessment of treatment efficacy, evaluation of endodontic materials, and analysis of periapical lesions.
Methods: A comprehensive search was conducted in PubMed and Google Scholar databases for relevant English-language articles published between 2021 and 2026. Studies utilizing µCT for various endodontic applications (root canal anatomy, instrumentation, obturation, retreatment, material evaluation, and periapical pathology) were included. Narrative synthesis was performed to summarize key findings, advantages, and limitations of µCT in these areas.
Results: The µCT provides high-resolution, non-destructive three-dimensional imaging that enables detailed qualitative and quantitative analysis of internal tooth structures, which is superior to conventional 2D radiography in visualizing complex anatomical features such as accessory canals, isthmuses, and apical deltas. Recent studies have used µCT to evaluate the efficacy of different instrumentation systems, obturation techniques, and removal of filling materials, as well as to assess the performance of novel endodontic materials (e.g., sealers and bioceramics). It has also facilitated precise volumetric quantification of periapical lesions in ex-vivo models. However, most applications remain ex-vivo due to high radiation doses and equipment costs, which currently limit routine in-vivo clinical use.
Conclusion: Micro-CT is a valuable endodontic research tool, offering high-resolution, non-destructive 3D imaging for studying root canal anatomy and comparing treatments. Despite cost and radiation limitations, advances in technology and AI may expand its use. Clinical impact remains unproven and requires standardized protocols and robust trials.