Application of Periapical Radiography in Root Canal Treatment: A Literature Review

Background: Periapical radiography is an essential imaging modality in endodontic practice due to its ability to visualize root canal anatomy and periapical structures in detail, with low cost and minimal radiation exposure. While CBCT delivers comprehensive 3D views, periapical radiography is still widely relied upon in routine dental procedures for its consistent performance in diagnosis and treatment monitoring. This paper seeks to systematically evaluate its application in root canal therapy and measure its diagnostic accuracy relative to CBCT. Methods: A literature review was conducted over a 14-day period using relevant keywords to search articles from PubMed and ScienceDirect databases. Selected articles met inclusion criteria based on publication year, topic relevance, and methodological appropriateness. Results: The findings indicate that periapical radiography is highly effective during diagnostic stages, working length determination, obturation assessment, and post-treatment follow-up in root canal therapy. Although CBCT demonstrates superiority in detecting accessory canals, root fractures, and hidden lesions with higher sensitivity, it is limited by higher costs, greater radiation exposure, and a risk of overdiagnosis. Periapical radiography continues to exhibit high reliability when performed with proper technique. Conclusion: Periapical radiography is effective throughout all stages of root canal treatment and remains the primary imaging modality due to its accuracy, affordability, and low radiation exposure. CBCT offers superior imaging in complex cases; however, its use should be selective and aligned with the ALADAIP principle. The choice of imaging should be based on clinical needs, effectiveness, and cost-efficiency.