Perforation Repair Endodontic
Perforation Repair Endodontic is a specialized dental service provided by the board-certified specialists at Aloha Dental Specialty Center in Beaverton, OR. Sub-millimeter 3D imaging that reveals hidden canals, fractures, and pathology invisible on standard X-rays.
Endodontic CBCT Scan: The 3D Imaging Technology That Changes Root Canal Outcomes
Cone-beam computed tomography (CBCT) has fundamentally changed how endodontists diagnose and plan treatment. A conventional dental X-ray produces a flat, two-dimensional shadow of a three-dimensional structure — roots overlap, hidden canals are obscured, and fractures aligned with the X-ray beam are invisible. CBCT produces a true three-dimensional volume of your tooth and surrounding bone at resolutions as fine as 75 micrometers (0.075 millimeters). At Aloha Dental Specialty Center, Dr. Ostovar uses in-office CBCT imaging as a standard diagnostic tool for complex endodontic cases, including retreatments, suspected fractures, resorption, anatomic variants, and pre-surgical planning for apicoectomy.
The scan itself takes approximately 15 seconds, during which the CBCT unit rotates around your head capturing hundreds of individual projections. The software reconstructs these into a 3D volume that Dr. Ostovar can slice in any plane — axial, sagittal, coronal, and oblique — scrolling through your tooth structure layer by layer. He can identify the MB2 canal in an upper molar, detect a C-shaped canal in a lower second molar, measure the curvature of a difficult root, locate a periapical lesion hidden by overlying anatomy, distinguish internal from external resorption, identify a vertical root fracture, and plan surgical access for apicoectomy — all before beginning treatment.
CBCT is not used on every case — it is prescribed when the diagnostic benefit exceeds the very modest radiation exposure. The effective dose from a small-volume endodontic CBCT scan is approximately 20 to 50 microsieverts — comparable to one to three standard dental X-rays and far less than a medical CT scan (200 to 600 microsieverts for a dental region). Dr. Ostovar follows the AAE and AAOMR joint position statement recommending CBCT when clinical examination and conventional radiography do not provide sufficient diagnostic information. For retreatment cases, suspected fractures, and surgical planning, CBCT is nearly always indicated.
Serving Beaverton, Aloha, Hillsboro & Washington County
Aloha Dental Specialty Center is located at 18455 SW Alexander St, Suite A, in Beaverton, Or 97003egon. We serve patients from across the Tualatin Valley and greater Portland metro, including Aloha, Hillsboro, Tigard, Lake Oswego, and Tualatin. Our Beaverton office is a 5-minute drive from Aloha, 10 minutes from Hillsboro, and 15 minutes from Tigard via SW 185th Avenue.
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Intel Campuses (Ronler Acres & Jones Farm)
10 to 15 minutes via NW 185th Ave. We accommodate the schedules of tech professionals who need efficient, high-quality specialty care.
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Nike World Headquarters
About 8 minutes via SW Baseline Rd. We frequently see patients from the Nike campus for surgical and implant procedures with sedation options.
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Streets of Tanasbourne & Orenco Station
Easily accessible via US-26 and NW 185th. Local general dentists in these communities regularly refer patients to us for specialty procedures.
Why Local Dentists Refer to Us
We work as a trusted partner to general dentists throughout the Tualatin Valley. When cases require CBCT-guided planning, IV sedation, bone grafting, or other advanced procedures, local providers refer to Dr. Ostovar for his fellowship-trained expertise and predictable results.
We handle the complex surgical phases and coordinate closely with your general dentist for seamless continuity of care from start to finish.
Understanding Your Investment
At Aloha Dental Specialty Center, we provide transparent pricing before any treatment begins. The cost of your procedure depends on clinical complexity, materials used, and sedation requirements. We walk you through every line item during your consultation so there are no surprises.
What Affects Cost:
- Clinical Complexity: Bone loss, sinus proximity, nerve involvement, or the need for grafting affects treatment planning and surgical time.
- Materials: We use research-backed implant systems, purified bone graft matrices, and high-strength ceramics from established manufacturers.
- Sedation: Options range from local anesthesia to IV sedation, each with different associated costs. We discuss the best option for your comfort and procedure.
Insurance & Financing
We accept most major dental insurance plans and file claims on your behalf. Our team verifies your benefits before treatment and submits pre-treatment estimates with clinical documentation to maximize coverage.
For out-of-pocket costs, we partner with CareCredit and Cherry for flexible payment plans. We also offer our ADSC Dental Savings Plan for patients without insurance.
Recovery & Healing Timeline
Understanding the healing process helps you plan ahead and follow post-operative instructions for the best possible outcome.
First 48 Hours
Mild swelling and tenderness are normal. Apply ice packs in 20-minute intervals and take prescribed or over-the-counter anti-inflammatory medication. Eat soft foods and avoid the surgical site when chewing.
Days 3 to 7
Swelling peaks around day three and then improves. The tissue begins closing over the surgical site. Continue with soft foods and use any prescribed antimicrobial rinse. Most patients return to normal activities during this phase.
Long-Term Healing
Surface tissue heals within two to three weeks. Bone integration and deep healing continue for three to six months. Avoid smoking, follow up as scheduled, and maintain good oral hygiene throughout recovery.
Questions during recovery? Call us at (503) 822-0096. We are available for post-operative concerns.
CBCT in Endodontics: What the Research Shows
Multiple systematic reviews confirm that CBCT significantly improves diagnostic accuracy in endodontics. For detecting periapical pathology, CBCT identifies lesions 34 to 62 percent more frequently than periapical radiographs, particularly in posterior teeth where overlying anatomy obscures the root apices. For identifying additional canals, CBCT detects the MB2 canal in upper molars with 93 to 97 percent accuracy versus 45 to 65 percent for periapical radiographs. For vertical root fracture detection, CBCT sensitivity ranges from 79 to 88 percent — imperfect, but substantially superior to the 20 to 30 percent detection rate of conventional films. For resorption diagnosis, CBCT provides three-dimensional classification that determines treatment approach. The AAE/AAOMR joint position statement (2015, reaffirmed 2021) recommends limited-volume CBCT as the imaging modality of choice when conventional radiography provides insufficient diagnostic information for endodontic cases.
Why Choose a Specialist?
Dr. Merat Ostovar integrates CBCT 3D imaging into his endodontic practice at Aloha Dental Specialty Center, using it for retreatment planning, surgical planning, anatomic mapping, fracture detection, and resorption classification. The CBCT unit is located in-office for same-visit imaging and interpretation. Dr. Ostovar follows AAE/AAOMR imaging guidelines for appropriate case selection.
Your Perforation Repair Endodontic Treatment Steps
- Consultation & Exam: Comprehensive perforation repair endodontic evaluation with CBCT 3D imaging at our Beaverton office.
- Treatment Plan: Board-certified specialist discusses your perforation repair endodontic options, timeline, and costs.
- Treatment: Procedure performed with comfort options including sedation if needed.
- Follow-Up: Post-treatment monitoring and care coordination for optimal healing.
Schedule Your Appointment Today
Book a consultation with our board-certified specialists at Aloha Dental Specialty Center in Beaverton, OR. Call (503) 822-0096 Office hours: Monday through Friday 7 AM to 7 PM, Saturday and Sunday 8 AM to 2 PM. or request an appointment online.
Related Services at Aloha Dental Specialty Center:
Dental Implants · Oral Surgery · Root Canal · Invisalign · Periodontics · Pediatric · TMJ Treatment · Sedation · Cosmetic · Emergency · Sleep Apnea
From Our Endodontic Team: Saving Your Natural Tooth
“I always tell patients: if we can save your natural tooth, that’s the best outcome. A well-done root canal with a good crown can last 15-20 years or more. The key is thoroughness — finding every canal, cleaning every curve, and sealing the system completely.
We use dental operating microscopes for every endodontic procedure. Under 20x magnification, I can see things that are invisible to the naked eye — hairline cracks, calcified canals, missed anatomy from a previous treatment. This is why retreatments done under a microscope have significantly higher success rates than those done without one.
The honest truth is that not every tooth can be saved. If there’s a vertical root fracture, or if bone loss around the root is too severe, extraction and implant may give you a better long-term result. I’ll always give you my honest assessment — I’d rather tell you the truth than do a procedure that’s likely to fail.”
— Endodontic Team, Aloha Dental Specialty Center, Beaverton, OR
I know many patients feel anxious about dental procedures — you’re not alone in that. What I hear most often after treatment is: “That was so much easier than I expected.” We’re here to make this as comfortable as possible for you.
Are You a Candidate for Perforation Repair Endodontic?
Most patients in good general health are candidates for perforation repair endodontic. However, certain factors may affect your eligibility or require modifications to the treatment plan:
- Medical conditions: Uncontrolled diabetes, autoimmune disorders, or blood-thinning medications may require coordination with your physician before treatment.
- Bone quality: For perforation repair endodontic involving the jawbone, adequate bone density is essential. A CBCT 3D scan during your consultation determines this precisely.
- Smoking: Tobacco use significantly impairs healing. We strongly recommend quitting 2-4 weeks before and after any surgical procedure.
- Age: There is generally no upper age limit. What matters is your overall health, not your age. We have successfully treated patients in their 80s and 90s.
The only way to know for certain is a consultation with our board-certified specialists. Call (503) 822-0096 to schedule your evaluation — we’ll tell you honestly whether this is the right treatment for your situation.
Typical Healing Timeline:
Days 1-3: Initial healing, mild swelling managed with ice and medication. Days 4-7: Swelling subsides, gradual return to normal diet. Weeks 2-4: Soft tissue heals completely. Months 2-6: Bone remodeling and full integration (for surgical procedures). Individual recovery varies — we provide detailed post-op instructions specific to your procedure.
For additional clinical information, visit the American Dental Association (ADA).
Last reviewed by our dental specialists: March 2026. Clinical information on this page reflects current evidence-based dental practices.
Related Dental Services
Frequently Asked Questions
What is a CBCT scan?
CBCT (cone-beam computed tomography) is a specialized 3D X-ray that produces a detailed volumetric image of your teeth, roots, and surrounding bone. Unlike a conventional dental X-ray (which is flat and 2D), CBCT lets the endodontist view your tooth from every angle and scroll through it layer by layer.
Is a CBCT scan safe? How much radiation is involved?
Yes, CBCT is very safe. A small-volume endodontic CBCT scan delivers approximately 20 to 50 microsieverts — comparable to one to three standard dental X-rays. For comparison, a medical CT scan of the head delivers 200 to 600 microsieverts, and the average person receives about 3,000 microsieverts per year from natural background radiation.
How long does a CBCT scan take?
The scan itself takes approximately 10 to 20 seconds. The entire process — positioning, scanning, and initial image review — takes about five minutes. The images are available immediately on the computer for Dr. Ostovar to review with you before treatment begins.
When is CBCT recommended instead of a regular dental X-ray?
CBCT is recommended when conventional X-rays do not provide enough information for diagnosis or treatment planning. Common indications include root canal retreatment, suspected root fracture, resorption diagnosis, unusual canal anatomy, pre-surgical planning for apicoectomy, dental trauma evaluation, and cases where previous treatment has failed without clear explanation.
Can CBCT show a tooth crack or fracture?
CBCT can detect many root fractures that are invisible on conventional X-rays, particularly fractures in the buccolingual direction. However, very fine fractures and those obscured by existing root canal filling materials may not be visible even on CBCT. Detection rates for vertical root fractures on CBCT range from 79 to 88 percent in published studies.
How does CBCT help find hidden canals?
CBCT reveals canal anatomy in three dimensions with sub-millimeter resolution. The MB2 canal in upper molars, the second canal in lower incisors, and variant canal configurations in premolars are clearly visible on CBCT axial slices. Studies show CBCT detects additional canals at rates of 93 to 97 percent — far exceeding the 45 to 65 percent detection rate of conventional radiographs.
Is the CBCT scan done in your office or do I go somewhere else?
Our CBCT unit is located right in our Beaverton office. The scan is performed on-site during your appointment, and Dr. Ostovar reviews the images with you immediately. There is no need to visit a separate imaging center or wait for results to be sent back.
Does insurance cover an endodontic CBCT scan?
Many dental insurance plans cover CBCT imaging under diagnostic radiology benefits, particularly when prescribed for specific diagnostic indications. Coverage varies by plan and carrier. We verify your benefits and inform you of any out-of-pocket cost before the scan is taken.
Can I see my CBCT images?
Absolutely. Dr. Ostovar reviews the CBCT images with you on the screen, showing you the specific findings — canals, lesions, fractures, or other pathology — in language you can understand. We believe patients make better decisions when they can see the problem for themselves.
What is a root perforation and how does it happen?
A root perforation is an unintended opening through the root wall into the surrounding bone, usually occurring during root canal access, post space preparation, or internal resorption. At ADSC, our endodontist uses microscopic visualization and MTA (mineral trioxide aggregate) to seal perforations with a 85-90% success rate when treated promptly.
Do I need to prepare for a CBCT scan?
No special preparation is needed. You will be asked to remove any metal jewelry, earrings, or glasses that might interfere with the image. The scan is performed while you are standing or sitting. You simply hold still for 10 to 20 seconds while the unit rotates around your head. There is no injection or contrast dye required.
Can CBCT detect infections around a root tip?
Yes. CBCT detects periapical lesions (infections around the root tip) 34 to 62 percent more frequently than conventional X-rays. This is because conventional X-rays require approximately 30 to 50 percent bone mineral loss before a lesion becomes visible, while CBCT can detect lesions with less mineral change. Early detection allows earlier treatment.
How does CBCT help with apicoectomy planning?
CBCT shows the exact position of the root apex relative to surrounding structures (maxillary sinus, inferior alveolar nerve, mental foramen), the thickness of the overlying bone, the presence of isthmuses between canals at the resection level, and the extent of the periapical lesion. This information allows precise surgical planning and reduces complications.
Is CBCT used for every root canal patient?
No. CBCT is prescribed selectively when the diagnostic benefit exceeds the modest radiation exposure. Straightforward anterior root canals on teeth with clear conventional X-rays may not require CBCT. Complex cases — retreatments, molars with variant anatomy, suspected fractures, resorption, and surgical cases — are the primary indications.
Can CBCT distinguish between internal and external resorption?
Yes. This is one of CBCT's most valuable applications. Internal resorption appears as a smooth-walled expansion centered within the canal space. External resorption appears as an irregularly bordered defect centered on the external root surface. The distinction is critical because treatment approaches differ significantly. Conventional X-rays can confuse these two conditions.
Get a 3D Picture of Your Tooth Before Treatment — Schedule a CBCT Consultation
Call our Beaverton office or request an appointment online. We look forward to helping you.
Clinically Reviewed by Dr. Merat Ostovar, DMD
Doctor of Dental Medicine | Implant & Specialty Dentistry | 15+ Years Experience
Aloha Dental Specialty Center — Serving Aloha, Beaverton, Hillsboro & Greater Portland
Last updated: March 19, 2026